PMID- 17106656
OWN - NLM
STAT- MEDLINE
DCOM- 20070709
LR  - 20220409
IS  - 0342-4642 (Print)
IS  - 0342-4642 (Linking)
VI  - 33
IP  - 1
DP  - 2007 Jan
TI  - Postresuscitation myocardial dysfunction: correlated factors and prognostic 
      implications.
PG  - 88-95
AB  - OBJECTIVE: To evaluate the clinical factors correlated with postresuscitation 
      myocardial dysfunction and the prognostic implication such dysfunction may have. 
      DESIGN AND SETTING: Prospective observational study in a university medical 
      center PATIENTS: 58 adult patients successfully resuscitated from nontraumatic 
      out-of-hospital cardiac arrest over 2 years. MEASUREMENTS AND RESULTS: 
      Echocardiographic evaluation of the left ventricular systolic and diastolic 
      functions was performed 6 h postresuscitation and was analyzed in correlation to 
      the clinical features and resuscitation factors. Univariate analysis revealed 
      left ventricular ejection fraction (LVEF) to be significantly lower in patients 
      with hypertension, past history of myocardial infarction, resuscitation duration 
      longer than 20 min, defibrillation, and use of more than 5 mg epinephrine. 
      Isovolumic relaxation time (IVRT) was significantly longer in patients with 
      noncardiac cause and initial rhythm of nonventricular fibrillation/tachycardia. 
      Multiple regression analysis showed epinephrine dose and past history of 
      myocardial infarction to be independent factors for LVEF, while the cause of 
      cardiac arrest was independently associated with IVRT. For prognosis, 27 patients 
      survived to hospital discharge. Both LVEF under 40% and IVRT 100 ms or longer 
      were associated with poor survival outcomes. In Cox regression analysis IVRT 100 
      ms or longer served as an independent factor predicting poor survival prognosis. 
      CONCLUSIONS: Postresuscitation left ventricular dysfunction is correlated with a 
      number of clinical factors, among which past history of myocardial infarction, 
      epinephrine dose, and the cause of cardiac arrest play independent roles. 
      Meanwhile, IVRT 100 ms or longer 6 h postresuscitation predicts poor survival 
      outcomes and serves as a marker of poor prognosis.
FAU - Chang, Wei-Tien
AU  - Chang WT
AD  - Department of Emergency Medicine, National Taiwan University Hospital and 
      National Taiwan University College of Medicine, Chung-Shan South Road 7, 100, 
      Taipei, Taiwan, R.O.C.
FAU - Ma, Matthew Huei-Ming
AU  - Ma MH
FAU - Chien, Kuo-Liong
AU  - Chien KL
FAU - Huang, Chien-Hua
AU  - Huang CH
FAU - Tsai, Min-Shan
AU  - Tsai MS
FAU - Shih, Fuh-Yuan
AU  - Shih FY
FAU - Yuan, Ann
AU  - Yuan A
FAU - Tsai, Kuang-Chau
AU  - Tsai KC
FAU - Lin, Fang-Yue
AU  - Lin FY
FAU - Lee, Yuan-Teh
AU  - Lee YT
FAU - Chen, Wen-Jone
AU  - Chen WJ
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20061115
PL  - United States
TA  - Intensive Care Med
JT  - Intensive care medicine
JID - 7704851
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - *Cardiopulmonary Resuscitation
MH  - Female
MH  - Heart/*physiopathology
MH  - Heart Arrest/*therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Contraction
MH  - Prognosis
MH  - Prospective Studies
MH  - Stroke Volume
EDAT- 2006/11/16 09:00
MHDA- 2007/07/10 09:00
CRDT- 2006/11/16 09:00
PHST- 2006/03/28 00:00 [received]
PHST- 2006/10/06 00:00 [accepted]
PHST- 2006/11/16 09:00 [pubmed]
PHST- 2007/07/10 09:00 [medline]
PHST- 2006/11/16 09:00 [entrez]
AID - 10.1007/s00134-006-0442-9 [doi]
PST - ppublish
SO  - Intensive Care Med. 2007 Jan;33(1):88-95. doi: 10.1007/s00134-006-0442-9. Epub 
      2006 Nov 15.