Three-Dimensional Echocardiography-Derived Right Ventricular Ejection Fraction Correlates with Success of Decannulation and Prognosis in Patients Stabilized by Venoarterial Extracorporeal Life Support
Journal
Journal of the American Society of Echocardiography
Journal Volume
31
Journal Issue
2
Pages
169-179
Date Issued
2018
Author(s)
Abstract
Venoarterial extracorporeal membrane oxygenation (VA-ECMO) has been proved to effectively rescue patients from refractory cardiogenic shock. The role of the right ventricle in VA-ECMO has been emphasized, but quantitative right ventricular (RV) analysis in this population has been lacking. Three-dimensional echocardiography (3DE) is currently suggested for RV volumetric analysis. The aims of this study were to assess 3DE-derived RV ejection fraction (RVEF) in patients with refractory cardiogenic shock stabilized by VA-ECMO and to explore the association between 3DE-derived RVEF and weaning success as well as the prognosis after the first intent of decannulation. Three-dimensional echocardiographic data sets before the first intent of decannulation were retrospectively selected and analyzed in 46 patients who underwent VA-ECMO for refractory acute circulatory collapse. Twenty-eight of the 46 patients had protocol-defined success in weaning from VA-ECMO. In the success group, both ventricles were smaller and had better pumping function. By stepwise multivariate linear regression, RV free wall strain, left ventricular ejection fraction, RV fractional area change, and central venous pressure were found to be independently associated with RVEF. Receiver operating characteristic curve analysis showed that RVEF had the highest area under the curve (0.90, P 24.6% was associated with higher weaning success and lower 30-day mortality after the first intent of decannulation.
SDGs
Other Subjects
adult; aged; all cause mortality; Article; cardiogenic shock; clinical article; clinical effectiveness; controlled study; decannulation; extracorporeal oxygenation; extracorporeal therapy; female; heart catheterization; heart right ventricle ejection fraction; heart ventricle contractility; human; male; middle aged; outcome assessment; predictive value; prognosis; receiver operating characteristic; reproducibility; thoracotomy; three dimensional echocardiography; venoarterial extracorporeal life support; very elderly; young adult; cardiogenic shock; diagnostic imaging; heart left ventricle function; heart right ventricle function; heart stroke volume; heart ventricle; pathophysiology; physiology; procedures; retrospective study; three dimensional echocardiography; Adult; Aged; Aged, 80 and over; Echocardiography, Three-Dimensional; Extracorporeal Membrane Oxygenation; Female; Heart Ventricles; Humans; Male; Middle Aged; Retrospective Studies; ROC Curve; Shock, Cardiogenic; Stroke Volume; Ventricular Function, Left; Ventricular Function, Right
Publisher
Mosby Inc.
Type
journal article