Document Detail


Measurement of myocardial contractility following successful resuscitation: quantitated left ventricular systolic function utilising non-invasive wall stress analysis.
MedLine Citation:
PMID:  9918448     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
After successful resuscitation from cardiac arrest, prolonged contractile failure has been demonstrated in animal experiments. No systematic evaluation of myocardial contractility following successful resuscitation after human cardiac arrest exists. The aim of this study was to assess left ventricular contractility following human cardiac arrest with successful resuscitation. In 20 adult patients after cardiac arrest and in four control patients, the relation between meridional wall stress (MWS) and rate-corrected mean velocity of circumferential fibre shortening (Vcf(c)), a load independent and rate corrected index of left ventricular contractility was measured within 4 h after return of spontaneous circulation and after 24 h by means of transoesophageal echocardiography. As the normal values of Vcf(c) depend on MWS, a normal deviate (z) was calculated. A normal z-score is defined as 0+/-2, < -2 indicates reduced contractility, > + 2 increased contractility. Data are presented as median and the interquartile range (IQR). For the comparison of related samples the Wilcoxon sign test was used. In most patients after cardiac arrest contractility was severely impaired within 4 h after successful resuscitation [z - 7.0 (IQR - 8.9 - (-2.5))]. Contractility did not significantly improve within the observational period [z after 24 h - 3.7 (IQR - 7.9 - (-1.8))] (P = 0.3). The four control patients had normal left ventricular contractility on arrival (z 0.0, range - 0.9-0.8) and after 24 h (z 0.7, range - 1.5-2.7). In conclusion non-invasive wall stress analysis can be applied to quantitate systolic left ventricular function, which was severely compromised in most patients within the first 24 h after successful resuscitation. Whether depression of left ventricular function is caused by cardiac arrest itself or by the underlying disease remains speculative.
Authors:
M Müllner; H Domanovits; F Sterz; H Herkner; G Gamper; I Kürkciyan; A N Laggner
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Resuscitation     Volume:  39     ISSN:  0300-9572     ISO Abbreviation:  Resuscitation     Publication Date:    1998 Oct-Nov
Date Detail:
Created Date:  1999-04-14     Completed Date:  1999-04-14     Revised Date:  2009-08-25    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  IRELAND    
Other Details:
Languages:  eng     Pagination:  51-9     Citation Subset:  IM    
Affiliation:
Department of Emergency Medicine, Vienna General Hospital-University of Vienna, Medical School, Austria. marcus.muellner@univie.ac.at
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Cardiopulmonary Resuscitation*
Echocardiography, Transesophageal
Female
Heart Arrest / physiopathology*,  therapy
Humans
Male
Middle Aged
Myocardial Contraction / physiology*
Myocardial Infarction / complications
Systole / physiology*
Time Factors
Ventricular Function, Left / physiology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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