Abstract 18275: Serial Echocardiography Demonstrates Reversible Myocardial Dysfunction After Resuscitation From Cardiac Arrest
Introduction: Reversible myocardial dysfunction after cardiac arrest (CA) appears common, but few studies have performed serial echocardiography in patients resuscitated from CA.
Hypothesis: Evidence of reversible LV systolic dysfunction will be identified on serial echocardiography early after CA.
Methods: We prospectively performed repeat transthoracic echocardiography (TTE) between 72 and 96 hours after CA in 17 patients who had undergone an initial TTE within 24 hours after CA. We compared mean values derived from 2D measurements, LVEF, spectral Doppler of mitral inflow and LV outflow, and peak systolic and early diastolic tissue Doppler of the mitral annulus between echocardiograms using paired t-tests. Mean changes in TTE parameters were compared between hospital survivors and non-survivors using paired t-tests.
Results: In these 17 subjects, there were significant increases in LV fractional shortening (+0.12, p = 0.028), LV outflow tract velocity-time integral (+3.82cm, p = 0.002) and both septal (+2.6, p = 0.016) and lateral (+1.8, p = 0.014) mitral annular systolic tissue Doppler (s’) velocities on repeat TTE. There were nonsignificant increases in estimated LVEF (+11.25%, p = 0.063) and TAPSE (+0.32, p = 0.065) between initial and repeat TTE. Other TTE parameters did not differ significantly between initial and repeat TTE, although not all parameters were available in all patients. Hospital non-survivors had a significant decrease in their LV end-systolic diameter (-0.68cm, p = 0.0161) and a non-significant decrease in their LV end-diastolic diameter (-0.4cm, p = 0.0549) on repeat TTE, whereas survivors did not. Changes in both septal (6 vs. 1.5, p = 0.0044) and lateral (3.67 vs. 0.88, p = 0.0161) mitral annular s’ velocities were higher in non-survivors. Other changes in echocardiographic parameters did not significantly differ between survivors and non-survivors.
Conclusions: LV fractional shortening, LV outflow tract velocity time integral and mitral annular s’ velocities increase between 24 hours and 72-96 hours after CA, consistent with reversible myocardial dysfunction. Hospital non-survivors had greater changes in LV dimensions and mitral annular s’ velocities between 24 hours and 72-96 hours than hospital survivors.
Author Disclosures: J.C. Jentzer: None. A. Shafton: None. M. Chonde: None. G. Hickey: None. H. Abu-Daya: None. A. Althouse: None. J. Rittenberger: None.
- © 2015 by American Heart Association, Inc.