• Kei Sato, Louise See Hoe, Jonathan Chan, Nchafatso G Obonyo, Karin Wildi, Silver Heinsar, Sebastiano M Colombo, Carmen Ainola, Gabriella Abbate, Noriko Sato, Margaret R Passmore, Mahe Bouquet, Emily S Wilson, Kieran Hyslop, Samantha Livingstone, Andrew Haymet, Jae-Seung Jung, Kris Skeggs, Chiara Palmieri, Nicole White, David Platts, Jacky Y Suen, David C McGiffin, BassiGianluigi LiGLCritical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia.Prince Charles Hospital Northside Clinical Unit, Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.Intensive Care Un, and John F Fraser.
• Critical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia.
• Eur. J. Clin. Invest. 2024 Oct 1; 54 (10): e14259e14259.

BackgroundThe commonest echocardiographic measurement, left ventricular ejection fraction, can not necessarily predict mortality of recipients following heart transplantation potentially due to afterload dependency. Afterload-independent left ventricular stroke work index (LVSWI) is alternatively recommended by the current guideline; however, pulmonary artery catheters are rarely inserted in organ donors in most jurisdictions. We propose a novel non-invasive echocardiographic parameter, Pressure-Strain Product (PSP), as a potential surrogate of catheter-based LVSWI. This study aimed to investigate if PSP could correlate with catheter-based LVSWI in an ovine model of brain stem death (BSD) donors. The association between PSP and myocardial mitochondrial function in the post-transplant hearts was also evaluated.MethodsThirty-one female sheep (weight 47 ± 5 kg) were divided into two groups; BSD (n = 15), and sham neurologic injury (n = 16). Echocardiographic parameters including global circumferential strain (GCS) and global radial strain (GRS) and pulmonary artery catheter-based LVSWI were simultaneously measured at 8-timepoints during 24-h observation. PSP was calculated as a product of GCS or GRS, and mean arterial pressure for PSPcirc or PSPrad, respectively. Myocardial mitochondrial function was evaluated following 6-h observation after heart transplantation.ResultsIn BSD donor hearts, PSPcirc (n = 96, rho = .547, p < .001) showed the best correlation with LVSWI among other echocardiographic parameters. PSPcirc returned AUC of .825 to distinguish higher values of cardiomyocyte mitochondrial function (cut-off point; mean value of complex 1,2 O2 Flux) in post-transplant hearts, which was greater than other echocardiographic parameters.ConclusionsPSPcirc could be used as a surrogate of catheter-based LVSWI reflecting mitochondrial function.© 2024 The Author(s). European Journal of Clinical Investigation published by John Wiley & Sons Ltd on behalf of Stichting European Society for Clinical Investigation Journal Foundation.

20 keywords...

hide…