Abstract
Aim
Current international guidelines recommend early echocardiography after resuscitated
sudden death despite limited data. Our aim was to analyze published data on early
post-resuscitation echocardiography to identify cardiac causes of sudden death and
prognostic implications.
Methods
We reviewed MEDLINE, EMBASE, and CENTRAL databases to December 2021 for echocardiographic
studies of adult patients after resuscitation from non-traumatic sudden death. Studies
were included if echocardiography was performed <48 hours after resuscitation and
reported (1) diagnostic accuracy to detect cardiac etiologies of sudden death or (2)
prognostic outcomes. Diagnostic endpoints were associations of regional wall motion
abnormalities (RWMA), ventricular function, and structural abnormalities with cardiac
etiologies of arrest. Prognostic endpoints were associations of echocardiographic
findings with survival to hospital discharge and favorable neurological outcome.
Results
Of 2877 articles screened, 16 (0.6%) studies met inclusion criteria, comprising 2035
patients. Two of six studies formally reported diagnostic accuracy for echocardiography
identifying cardiac etiology of arrest; RWMA (in 5 of 6 studies) were associated with
presumed cardiac ischemia in 17–89% of cases. Among 12 prognostic studies, there was
no association of reduced left ventricular ejection fraction with hospital survival
(v10) or favorable neurologic status (n = 5). Echocardiographic high mitral E/e′ ratio (n = 1) and right ventricular systolic dysfunction (n = 2) were associated with poor survival.
Conclusion
This scoping review highlights the limited data on early echocardiography in providing
etiology of arrest and prognostic information after resuscitated sudden death. Further
research is needed to refine the clinical application of early echocardiographic findings
in post arrest care.
Keywords
Abbreviations:
ACS (acute coronary syndrome), CAD (coronary artery disease), ICA (invasive coronary angiography), IHCA (in hospital cardiac arrest), LVEF (left ventricular ejection fraction), OHCA (out of hospital cardiac arrest), PAMD (post-arrest myocardial dysfunction), RWMA (regional wall motion abnormalities), RV (right ventricular), TAPSE (tricuspid annular plane systolic excursion), VT/VF (ventricular tachycardia/ventricular fibrillation)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: February 01, 2023
Accepted:
January 25,
2023
Received in revised form:
January 18,
2023
Received:
December 2,
2022
Identification
Copyright
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