• Journal of critical care · Apr 2023

    Right ventricular echocardiographic parameters and prediction of stroke volume in ischemic cardiogenic shock: A retrospective study.

    • Hazem Lashin, Olusegun Olusanya, Andrew Smith, and Sanjeev Bhattacharyya.
    • Adult Critical Care Unit, Barts Heart Centre, St Bartholomew's Hospital, West Smithfield, London, UK; William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London, UK. Electronic address: h.lashin@qmul.ac.uk.
    • J Crit Care. 2023 Apr 1; 74: 154219154219.

    PurposeThis study investigated which commonly used right ventricular (RV) echocardiographic parameter correlates best with stroke volume (SV) estimated by Doppler echocardiography in ischemic cardiogenic shock (CS).Materials And MethodsWe retrospectively reviewed the records of 100 patients admitted to the ICU over 34 months with CS. Tricuspid annular plane systolic excursion (TAPSE), Tricuspid annulus systolic velocity (RV S'), Tricuspid regurgitation maximum velocity (TR Vmax), and RV outflow tract velocity time integral (RVOT VTI) were correlated to SV.ResultsMean age was 62.6 ± 12.7 years and 78% were male. The mean SV, TAPSE, RV S', TR Vmax, and RVOT VTI were 47 ± 16 ml, 16 ± 5 mm, 11 ± 4 mm/s, 1.97 ± 0.73 m/s, and 12.7 ± 5 cm, respectively. RVOT VTI correlated best to SV (r = 0.39 p = 0.01) compared to TAPSE, RV S', and TR Vmax (r = 0.26 p = 0.01, r = 0.15 p = 0.21, r = 0.03 p = 0.78). RVOT VTI independently predicted SV. Univariate analysis demonstrated that only RVOT VTI predicted SV (OD = 1.18 p = 0.04) and had the best area under the curve (0.70, p = 0.03).ConclusionRVOT VTI correlated better (albeit weakly) to and best predicted SV compared to TAPSE, RV S', and TR Vmax in patients admitted to intensive care with CS. This study suggests that RVOT VTI has the potential as a therapeutic target to optimize SV in CS.Copyright © 2022 Elsevier Inc. All rights reserved.

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