Key result
Average peak systolic mitral annular velocity (s') assessed on serial echocardiograms was not associated with 180-day neurological outcome in comatose survivors of out-of-hospital cardiac arrest.
Why the study?
Transthoracic echocardiographic indices of myocardial function in OHCA survivors have shown inconsistent relationships with neurological outcome.
Does average peak systolic mitral annular velocity (s') predict 180-day neurological outcome in comatose out-of-hospital cardiac arrest survivors treated with targeted temperature management?
Cohort (n=99)
Single-blind
No
Does average peak systolic mitral annular velocity (s') predict 180-day neurological outcome in comatose out-of-hospital cardiac arrest survivors treated with targeted temperature management?
Serial echocardiographic parameters, including s', assessed in the early post-resuscitation phase during targeted temperature management do not aid in prognosticating 180-day neurological outcome following out-of-hospital cardiac arrest.
Background: Transthoracic echocardiographic (TTE) indices of myocardial function among survivors of out-of-hospital cardiac arrest (OHCA) have been related to neurological outcome; however, results are inconsistent. We hypothesized that changes in average peak systolic mitral annular velocity (s’) from 24 hours (h) to 72 h following start of targeted temperature management (TTM) predict six-month neurological outcome in comatose OHCA survivors.Methods: We investigated the association between peak systolic velocity of the mitral plane (s’) and six-month neurological outcome in a population of 99 patients from a randomised controlled trial comparing TTM at 33±1°C for 24 hours (h) (n=47) vs. 48h (n=52) following OHCA (TTH48-trial). TTE was conducted at 24h, 48h, and 72h after reaching target temperature. The primary outcome was 180 days neurological outcome assessed by Cerebral Performance Category score (CPC180) and the primary TTE outcome measure was s’. Secondary outcome measures were left ventricular ejection fraction (LVEF), global longitudinal strain (GLS), e’, E/e’ and tricuspid annular plane systolic excursion (TAPSE). Results: Across all three scan time points s’ was not associated with neurological outcome (ORs: 24 h: 1.0 (95%CI: 0.7-1.4, p=0.98), 48 h: 1.13 (95%CI: 0.9-1.4, p=0.34), 72 h: 1.04 (95%CI: 0.8-1.4, p=0.76)). LVEF, GLS, E/e’, and TAPSE recorded on serial TTEs following OHCA were neither associated with nor did they predict CPC180. Estimated median e’ at 48h following TTM was 5.74 cm/s (95%CI: 5.27-6.22) in patients with good outcome (CPC180 1-2) vs. 4.95 cm/s (95%CI: 4.37-5.54) in patients with poor outcome (CPC180 3-5) (p=0.04). Conclusions: s’ assessed on serial TTEs in comatose survivors of OHCA treated with TTM was not associated with CPC180. Our findings suggest that serial TTEs in the early post-resuscitation phase during TTM do not aid the prognostication of neurological outcome following OHCA.Trial registration: NCT02066753. Registered 14 February 2014 – Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02066753
No takes yet. Share an insight, caveat, or question.
Jensen et al. (2021) conducted a cohort in Out-of-hospital cardiac arrest (OHCA) (n=99). Average peak systolic mitral annular velocity (s') vs. Unexposed/reference group was evaluated on 180-day poor neurological outcome (Cerebral Performance Category score 3-5) (OR 1.0, 95% CI 0.7-1.4, p=0.98). Average peak systolic mitral annular velocity (s') assessed on serial echocardiograms was not associated with 180-day neurological outcome in comatose survivors of out-of-hospital cardiac arrest.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: