engleski

The role of global LV strain assessed with automated function imaging (AFI) after successful ECMO-cardiopulmonary resuscitation in acute coronary syndrome

Patients with acute coronary syndrome and cardiogenic shock not responding to standard cardiopulmonary resuscitation (CRP) can be resuscitated by veno-arterial extracorporeal membrane oxygenation (ECMO). The extent of viable myocardial tissue (or stunned myocardium) is recognized as a major determinant of recovery of left ventricular (LV) function. The purpose of the study was to assess the early post-arrest LV function by echocardiography global LV strain assessed with automated function imaging (AFI). We hypothesize that a significant early post-arrest LV dysfunction could be demonstrated with this model using global longitudinal strain. In eight patients, veno-arterial ECMO in cardiogenic shock in ACS was used. In patients undergoing coronary angiography and ECMO, myocardial deformation parameters were measured in acute setting after successful ECMO- cardiopulmonary resuscitation. All patients underwent 2D echocardiography within 48 hours of weaning from the ECMO circuit, and 4-6 weeks after reperfusion therapy and ECMO. All patients were successfully resuscitated, weaned from the ECMO circuit, and haemodynamically stabilized. After 4-6 weeks improvement showed in both regional and global longitudinal strain in all seven patients, but values of global and regional (depending on the region of acute myocardial infarction) longitudinal strain assessed with AFI were still greater than or equal to - 12%. Post arrest cardiac dysfunction after circulatory failure is clinical problem which increases the risk of adverse events so detailed knowledge of cardiac function is therefore needed in decision making.

global LV strain ; ECMO ; acute coronary syndrome

Rad je prezentiran na World Congress of Cardiology Scientific Sessions 2016, Mexico City, Mexico