Abstract
Determination of clinical outcomes following resuscitation from cardiac arrest remains elusive in the immediate post-arrest period. Echocardiographic assessment shortly after resuscitation has largely focused on left ventricular (LV) function. We aimed to determine whether post-arrest right ventricular (RV) dysfunction predicts worse survival and poor neurologic outcome in cardiac arrest patients, independent of LV dysfunction. A single-center, retrospective cohort study at a tertiary care university hospital participating in the Penn Alliance for Therapeutic Hypothermia (PATH) Registry between 2000 and 2012. 291 in- and out-of-hospital adult cardiac arrest patients at the University of Pennsylvania who had return of spontaneous circulation (ROSC) and post-arrest echocardiograms. Of the 291 patients, 57% were male, with a mean age of 59 ± 16 years. 179 (63%) patients had LV dysfunction, 173 (59%) had RV dysfunction, and 124 (44%) had biventricular dysfunction on the initial post-arrest echocardiogram. Independent of LV function, RV dysfunction was predictive of worse survival (mild or moderate: OR 0.51, CI 0.26-0.99, p<0.05; severe: OR 0.19, CI 0.06-0.65, p=0.008) and neurologic outcome (mild or moderate: OR 0.33, CI 0.17-0.65,...Continue Reading
References
Oct 1, 1991·Current Problems in Cardiology·L J Dell'Italia
Jul 1, 1996·Journal of the American College of Cardiology·K B KernR A Berg
Jun 17, 1997·Circulation·K B KernG A Ewy
Sep 13, 2003·Resuscitation·Mary Ann PeberdyTanya Lane-Trultt
Jun 26, 2004·Circulation Research·Stéphane ZaffranNigel A Brown
Oct 25, 2006·Circulation·Norbert F VoelkelUNKNOWN National Heart, Lung, and Blood Institute Working Group on Cellular and Molecular Mechanisms of Right Heart Failure
Feb 15, 2008·Critical Care Medicine·Clifford R Greyson
Mar 19, 2008·Circulation·François HaddadDaniel J Murphy
Apr 2, 2008·Circulation·Maria M GonzalezJose A Ramires
Oct 31, 2008·Resuscitation·Jerry P NolanTerry Vanden Hoek
Nov 27, 2008·American Heart Journal·Hyun KimAdam J Singer
Jan 20, 2009·Anesthesia and Analgesia·François HaddadAndré Y Denault
Oct 22, 2010·Circulation·Mary Ann PeberdyUNKNOWN American Heart Association
Jun 28, 2011·Critical Care Medicine·Raina M MerchantUNKNOWN American Heart Association Get With The Guidelines-Resuscitation Investigators
Sep 11, 2012·Lancet·Zachary D GoldbergerUNKNOWN American Heart Association Get With The Guidelines—Resuscitation (formerly National Registry of Cardiopulmonary Resuscitati
Dec 15, 2012·Circulation·Alan S GoUNKNOWN American Heart Association Statistics Committee and Stroke Statistics Subcommittee
Jan 1, 2013·Journal of Cardiac Failure·Amresh RainaJames N Kirkpatrick
Jan 4, 2013·Circulation·Alan S GoUNKNOWN American Heart Association Statistics Committee and Stroke Statistics Subcommittee
Jan 15, 2013·Resuscitation·Scott T YoungquistJohn P Rosborough
Mar 13, 2013·Circulation·Laurie J MorrisonUNKNOWN American Heart Association Emergency Cardiovascular Care Committee, Council on Cardiopulmonary, Critical Care, Perioperative
Jun 12, 2013·Life Sciences·George J CrystalM Ramez Salem
Aug 7, 2013·Resuscitation·Anne V GrossestreuerDavid F Gaieski
Sep 26, 2013·The American Journal of Cardiology·Matteo CameliSergio Mondillo
Nov 15, 2013·Circulation Journal : Official Journal of the Japanese Circulation Society·Ji-Hyun KimDae-Won Sohn
Dec 24, 2013·Archives of Cardiovascular Diseases·Vincent AuffretHervé Le Breton
Jan 7, 2015·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Roberto M LangJens-Uwe Voigt
Citations
May 18, 2016·Critical Care : the Official Journal of the Critical Care Forum·Koen AmelootMatthias Dupont
Jul 6, 2016·Resuscitation·Jacob C JentzerJon C Rittenberger
Apr 6, 2017·Resuscitation·Anders Morten GrejsHans Kirkegaard
Jun 28, 2019·Circulation·Alexis A TopjianMary Fran Hazinski
Dec 13, 2019·Acta Anaesthesiologica Scandinavica·Markus B SkrifvarsHans Kirkegaard
May 24, 2018·Intensive Care Medicine·Stephen J HuangAnthony S McLean
Jul 22, 2019·International Journal of Molecular Sciences·Andrew J Lautz, Basilia Zingarelli
Jul 8, 2019·Resuscitation·Ludvig ElfwénPer Nordberg
Aug 10, 2020·Shock·Fahad GulGabriel Patarroyo-Aponte
Feb 16, 2021·Frontiers in Medicine·Kei HayashidaLance B Becker
Feb 21, 2021·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Thomas Hvid JensenAnders Morten Grejs
May 29, 2021·Journal of Intensive Care Medicine·Meir TabiJacob C Jentzer
Aug 10, 2021·Chest·Jan StassenTim Balthazar