title: Echocardiographic left ventricular systolic dysfunction early after resuscitation from cardiac arrest does not predict mortality or vasopressor requirements.
abstract: Echocardiographic abnormalities are common after resuscitation from cardiac arrest. The association between echocardiographic findings with vasopressor requirements and mortality are not well described. We sought to determine the associations between echocardiographic abnormalities and mortality, vasopressor requirements and organ failure after cardiac arrest.
  
  
  
  We prospectively evaluated 55 adult subjects undergoing transthoracic echocardiography within 24h after resuscitation from cardiac arrest. We evaluated the association between 2D echocardiographic and Doppler measurements and mortality, Sequential Organ Failure Assessment (SOFA) scores and vasopressor requirements.
  
  
  
  Inpatient mortality was 60%. Mean left ventricular ejection fraction (LVEF) was 43.6%; LVEF was <40% in 36% of subjects. None of the measured echocardiographic parameters (including LVEF) was significantly associated with inpatient mortality (all p>0.1). Subjects with LVEF <40% more often had shockable arrest rhythms and patients resuscitated from shockable rhythms had lower mean LVEF (36.2% vs. 52.3%, p=0.001). There was no correlation between markers of right and left ventricular systolic or diastolic function (including LVEF and Doppler parameters) with vasopressor requirements, lactate levels or SOFA scores.
  
  
  
  Echocardiographic parameters (including LVEF) were not associated with inpatient mortality after cardiac arrest. Vasopressor requirements and organ failure severity were not associated with multiple echocardiographic markers of systolic function.
authors.affiliation: Divisions of Cardiovascular Diseases and Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States. Electronic address: jentzer.jacob@mayo.edu.
authors.forename: Jacob C
authors.initials: JC
authors.lastname: Jentzer
authors.affiliation: Heart and Vascular Institute, University of Pittsburgh Medical Center, 200 Lothrop Street, Pittsburgh, PA 15211, United States. Electronic address: chondem@upmc.edu.
authors.forename: Meshe D
authors.initials: MD
authors.lastname: Chonde
authors.affiliation: Heart Institute of Colorado, 1960 Ogden Street Suite 110, Denver, CO 80218, United States. Electronic address: asher.shafton@sclhs.net.
authors.forename: Asher
authors.initials: A
authors.lastname: Shafton
authors.affiliation: Department of Internal Medicine, University of Pittsburgh Medical Center, 200 Lothrop Street, Pittsburgh, PA 15211, United States. Electronic address: abudayah@upmc.edu.
authors.forename: Hussein
authors.initials: H
authors.lastname: Abu-Daya
authors.affiliation: Graduate School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA 15261, United States. Electronic address: didierchalhoub@gmail.com.
authors.forename: Didier
authors.initials: D
authors.lastname: Chalhoub
authors.affiliation: Heart and Vascular Institute, University of Pittsburgh Medical Center, 200 Lothrop Street, Pittsburgh, PA 15211, United States. Electronic address: althousead@upmc.edu.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Althouse
authors.affiliation: Department of Emergency Medicine, University of Pittsburgh, 3600 Forbes Avenue, Suite 400A, Pittsburgh, PA 15261, United States. Electronic address: rittjc@upmc.edu.
authors.forename: Jon C
authors.initials: JC
authors.lastname: Rittenberger
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D015415:Biomarkers / Q000032:analysis; D016887:Cardiopulmonary Resuscitation / Q000009:adverse effects*; D016009:Chi-Square Distribution; D004452:Echocardiography / Q000706:statistics & numerical data*; D005260:Female; D006323:Heart Arrest / Q000401:mortality* / Q000628:therapy; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D063305:Organ Dysfunction Scores; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013318:Stroke Volume; D014662:Vasoconstrictor Agents / Q000627:therapeutic use; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000401:mortality*
chemical_list: D015415:Biomarkers; D014662:Vasoconstrictor Agents
keywords: Cardiac arrest; Echocardiography; Shock; Systolic dysfunction; Vasopressors