Abstract 96: Normalization of Left Ventricle Ejection Fraction, Not Initial Left Ventricle Ejection Fraction, is Associated with Outcomes After Cardiac Arrest
Background: Many patients with cardiac arrest are initially resuscitated but far fewer survive to hospital discharge. Post-arrest myocardial dysfunction is common and associated with higher mortality. We describe myocardial dysfunction and its association with outcome at 4 hospitals.
Objectives: To discover the prevalence of left ventricle (LV) dysfunction in the first 24 hours post-arrest, the normalization of LV ejection fraction (LVEF) post-arrest, and determine their relationship to functional outcome at hospital discharge.
Methods: A multicenter retrospective study of 464 patients who underwent post-arrest echocardiography at 4 hospitals with aggressive post-arrest protocols including therapeutic hypothermia. Abnormal LVEF was defined as <50%.
Results: 357/464 (77%) patients had an echo within the 1st 24 hours post-arrest (mean age: 59±16 years, 62% male, 37% VT/VF, and 70% out-of-hospital). 206/357 (58%) had an abnormal LVEF within 24 hours. Analysis of survival and neurologic outcome of patients with an echo in the 1st 24 hours as well as a subsequent echo prior to discharge (180/357; 50%) showed patients with an abnormal LVEF that recovered had the best outcomes, while patients who had an initially normal LVEF had the worst outcomes, regardless of whether their LVEF changed (Table 1).
Conclusions: More than half of successfully resuscitated post-arrest patients had an abnormal LVEF in the 24 hours post arrest. An abnormal LVEF in the first 24 hours post-arrest did not predict negative outcome, and normalization of LVEF predicted good outcome. Prospective studies with echocardiography obtained at predetermined time points post-arrest are needed to further elucidate these findings.
- © 2013 by American Heart Association, Inc.