Abstract 90: Systolic and Diastolic Function in Cardiac Arrest Patients During Therapeutic Hypothermia
BACKGROUND: Previous studies and experience have suggested that the LVEF might be depressed in patients (pts) undergoing therapeutic hypothermia (TH) after cardiac arrest. We evaluated LV function by echocardiography (echo) during TH in pts with return of spontaneous circulation(ROSC) after cardiac resuscitation to observe whether TH may preserve cardiac function and contractile reserve compared to the patients without TH.
METHOD: Retrospective chart review on 54 out of 292 pts with ROSC between 2007 and 2010 including echo reports performed prior to, during admission, and follow-up period; excluding 125 pts with no ROSC, and 113 pts with clear non-cardiac cause for arrest, age <18 years, and no echo within 24 hrs of presentation post cardiac arrest.
RESULTS: 32 non-TH patients and 22 TH patients were included in the study after applying the exclusion criteria. The two groups differed by location of arrest, with the non-TH group having 13/32 (41%) and the TH group having 16/22 (73%) out of hospital arrests, (p-value=0.028). 17 (53%) non-TH patients and 7 (31%) TH patients survived to discharge. Systolic function after ROSC in pts undergoing TH (average core temperature: 33.3oC) and non-TH were 43 +/- 17% vs. 50 +/- 18% (P:NS), with normal EF (50-55%) in 7 vs. 17 pts (P:NS) and depressed EF (15-49%) in 15 vs. 15 pts (P:NS).Diastolic function in pts with TH and non-TH were normal in 6 vs. 10 pts, mild dysfunction in 3 vs. 6 pts, moderate dysfunction in 5 vs. 4 pts, severe dysfunction in 3 vs. 0 pts, and un-interpretable in 5 vs. 12 pts. (P:NS).Other echo variables i.e.systolic and diastolic dimension and LV mass indices were not statistically different in two groups.
CONCLUSION: There was a trend of reduction in LVEF, but no significant deterioration of LV systolic and diastolic function, suggesting TH may not adversely affect cardiac performance during the procedure. A long term improvement in cardiac function in this population linked to TH warrants further investigation to prove the hypothesis that a reduced LVEF may be related to cardioprotective features associated with decreased demand and consumption of energy in the myocardium during TH following cardiac arrest.
- © 2012 by American Heart Association, Inc.