Paolo Trambaiolo 1 , Ilaria Figliuzzi 2 , Marta Salvati 2 , Pietro Bertini 3 , Giulia Brizzi 3 , Giuliano Tocci 4 , Massimo Volpe 4 , Giuseppe Ferraiuolo 2 , Fabio Guarracino 3 Show Affiliations »
Abstract
AIMS: The aim of this study was to investigate the relationship between ventriculo-arterial coupling (VAC) and in-hospital outcomes and to assess the prognostic value of VAC in critically ill patients. METHODS AND RESULTS: A total of 329 consecutive patients (mean age 66,7 ± 15.5 years, 66.9% male) admitted to the intensive cardiac care unit of the Sandro Pertini Hospital, Rome (Italy) between January 2019 and December 2019, were included in the study. All patients underwent blood pressure measurement and non-invasive, echocardiography-derived estimates of left ventricular end-systolic elastance (Ees), arterial elastance (Ea) and VAC in a single-beat determination using the iElastance© application. In-hospital events related to acute heart failure and hypoperfusion were recorded and need for invasive ventilation, intra-aortic balloon pump, renal replacement therapy and death were considered as composite. Overall, 39 patients (11,8%) experienced in-hospital complications (group C), and 290 (88,2%) did not (group NoC). Ea and VAC were found to be significantly higher in group C than in group NoC, and a trend toward decreased Ees was observed in group C. VAC was a strong and independent predictor of in-hospital clinical outcome both at univariable and multivariable analysis adjusted for comorbidities [OR (95% CI): 1.868 (1.141-3.059); P = 0.013] and hemodynamic parameters [OR (95% CI): 1674 (1018-2755); P = 0.042]. CONCLUSION: VAC might be an additional non-invasive prognosticator of outcome in critically ill patients.
AIMS: The aim of this study was to investigate the relationship between ventriculo-arterial coupling (VAC) and in-hospital outcomes and to assess the prognostic value of VAC in critically ill patients. METHODS AND RESULTS: A total of 329 consecutive patients (mean age 66,7 ± 15.5 years, 66.9% male) admitted to the intensive cardiac care unit of the Sandro Pertini Hospital, Rome (Italy) between January 2019 and December 2019, were included in the study. All patients underwent blood pressure measurement and non-invasive, echocardiography-derived estimates of left ventricular end-systolic elastance (Ees), arterial elastance (Ea) and VAC in a single-beat determination using the iElastance© application. In-hospital events related to acute heart failure and hypoperfusion were recorded and need for invasive ventilation, intra-aortic balloon pump, renal replacement therapy and death were considered as composite. Overall, 39 patients (11,8%) experienced in-hospital complications (group C), and 290 (88,2%) did not (group NoC). Ea and VAC were found to be significantly higher in group C than in group NoC, and a trend toward decreased Ees was observed in group C. VAC was a strong and independent predictor of in-hospital clinical outcome both at univariable and multivariable analysis adjusted for comorbidities [OR (95% CI): 1.868 (1.141-3.059); P = 0.013] and hemodynamic parameters [OR (95% CI): 1674 (1018-2755); P = 0.042]. CONCLUSION: VAC might be an additional non-invasive prognosticator of outcome in critically ill patients.
Copyright © 2021 Elsevier B.V. All rights reserved.
Entities: Chemical
Keywords:
Critical care; Echocardiography; Non-invasive; Prognosis; Ventriculo-arterial coupling
Mesh： See more »
Year: 2021
PMID： 34933063 DOI： 10.1016/j.ijcard.2021.12.026
Source DB: PubMed Journal: Int J Cardiol ISSN： 0167-5273 Impact factor: 4.164