A novel echocardiographic parameter considering left ventricular afterload during V-A ECMO support

Sato K, Heinsar S, Chan J, Farah SM, Wildi K, Obonyo NG, Liu K, Ainola C, Sato N, Abbate G, Wilson ES, Bouquet M, Hyslop K, Passmore MR, Ijuin S, Ro SK, Fior G, Gandini L, Lundon B, Platts DG, Suen JY, Bassi GL, Fraser JF Eur J Clin Invest DOI 10.1111/eci.14263

Background: Left ventricular stroke work index (LVSWI) and cardiac power index (CPI) account for the haemodynamic load of the left ventricle and are promising prognostic values in cardiogenic shock. However, accurately and non-invasively measuring these parameters during veno-arterial extracorporeal membrane oxygenation (V-A ECMO) is challenging and potentially biased by the extracorporeal circulation. This study aimed to investigate, in an ovine model of cardiogenic shock, whether Pressure-Strain Product (PSP), a novel speckle-tracking echocardiography parameter, (1) can correlate with pressure-volume catheter-based LVSWI and CPI, and (2) can be load-independent during the flow modification of V-A ECMO.