Pulmonary and systemic hemodynamics are associated with myocardial injury in the acute respiratory distress syndrome

Autor: Thomas S Metkus, Stephen C Mathai, Thorsten Leucker, Paul M Hassoun, Ryan J Tedford, Frederick K Korley
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: Pulmonary Circulation, Vol 10 (2020)
Druh dokumentu: article
ISSN: 2045-8940
20458940
DOI: 10.1177/2045894020939846
Popis: Background Whether right and left heart hemodynamics are associated with myocardial injury in the acute respiratory distress syndrome (ARDS) is not known. Methods We performed a retrospective cohort study of subjects who had right heart catheterization within the ALVEOLI trial and Fluid and Catheter Treatment Trial. Myocardial injury was assessed using a highly sensitive troponin assay (hsTn; Abbot ARCHITECT). Hemodynamic variables included right atrial pressure, pulmonary artery wedge pressure, cardiac index and stroke volume, pulmonary vascular resistance, pulmonary arterial compliance, and pulmonary effective arterial elastance. We performed linear, logistic, and Cox regression to determine the association of hemodynamic variables with myocardial injury and to determine if hemodynamics mediated the association between myocardial injury and death. Results Among 252 ARDS patients, median day 0 troponin was 65.4 (13.8–397.8) ng/L. Lower cardiac index (β −0.23 SE 0.10; P
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