Association Between Right Ventricular Systolic Parameters Measured by Echocardiography and Stroke Volume Derived From Pulmonary Artery Catheter in Ischemic Cardiogenic Shock.

Autor: Lashin H; Adult Critical Care Unit, Barts Heart Centre, St Bartholomew's Hospital, West Smithfield, London, United Kingdom; William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London, United Kingdom. Electronic address: h.lashin@qmul.ac.uk., Olusanya O; Adult Critical Care Unit, Barts Heart Centre, St Bartholomew's Hospital, West Smithfield, London, United Kingdom., Smith A; Adult Critical Care Unit, Barts Heart Centre, St Bartholomew's Hospital, West Smithfield, London, United Kingdom; William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London, United Kingdom., Bhattacharyya S; William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London, United Kingdom; Cardiology Department, Barts Heart Centre, St Bartholomew's Hospital, West Smithfield, London, United Kingdom.
Jazyk: angličtina
Zdroj: Journal of cardiothoracic and vascular anesthesia [J Cardiothorac Vasc Anesth] 2024 Nov; Vol. 38 (11), pp. 2592-2600. Date of Electronic Publication: 2024 Jul 25.
DOI: 10.1053/j.jvca.2024.07.024
Abstrakt: Objective: To determine the right ventricular (RV) systolic function echocardiographic parameter best associated with native stroke volume (SV) by thermodilution via a pulmonary artery catheter (PAC) in patients admitted to intensive care with ST elevation myocardial infarction (STEMI) complicated by cardiogenic shock (CS).
Design, Setting, and Participants: An observational cohort study of 43 prospectively identified patients admitted to a tertiary cardiac intensive care unit in London, United Kingdom.
Interventions: Simultaneous collection of comprehensive transthoracic echocardiographic, clinical, and PAC-derived hemodynamic data. Seven RV systolic function parameters were correlated with the PAC-derived SV.
Measurements and Main Results: The median patient age was 61 years (interquartile range [IQR], 52-67 years), and 36 of the 43 patients (84%) were male. The median PAC-derived SV and left ventricular ejection fraction were 57 mL (IQR, 39-70 mL) and 31% (IQR, 22%-35%), respectively. The RV outflow tract velocity time integral (RVOT VTI) and tricuspid plane systolic excursion (TAPSE) correlated significantly with the PAC-derived SV (r = 0.42 [p = 0.007] and r = 0.37 [p = 0.02], respectively). The RVOT VTI was independently associated with and predicted low PAC-derived SV (odds ratio, 1.3; p = 0.03) with a good area under the curve (AUC = 0.71; p = 0.02). An RVOT VTI <12.7 cm predicted low PAC-derived SV with a sensitivity of 66% and specificity of 72%.
Conclusions: RVOT VTI is the echocardiographic RV systolic function parameter that best correlates with PAC-derived native SV in patients with STEMI complicated by CS. This parameter can help guide the hemodynamic management of this cohort.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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