A novel speckle-tracking echocardiographic parameter considering left ventricular loading condition in cardiogenic shock during VA ECMO
Kei Sato, Silver Heinsar, Karin Susanne Wildi, Nchafatso Obonyo, Keibun Liu, Samia Farah, Carmen Ainola, Noriko Sato, Gabriele Fior, Sun Kyun Ro, Lucia Gandini, Shinichi Ijuin, Mahe Bouquet, Emily Wilson, Margaret Passmore, Kieran Hyslop, Jonathan H. Chan, David Platts, Jacky Suen, Gianluigi Li Bassi, John Fraser. ScienceDirect DOI: 10.1016/S0735-1097(23)01840-5
Background: Left ventricular (LV) stroke work index (SWI) and cardiac power index (CPI) consider LV pre- and after-load and can yield better prognostic values in cardiogenic shock than conventional LV parameters such as ejection fraction (EF). However, these values based on a pulmonary artery catheter with thermodilution method may not be reliable during veno-arterial extracorporeal membrane oxygenation (VA ECMO). Pressure-Volume catheter (PVC)-based LV SWI and CPI could be more reliable, but it is too invasive for a clinical use. The aim of this study was to investigate whether Pressure-Strain Product (PSP), a novel Speckle-Tracking echocardiography (STE) parameter that incorporates blood pressure with LV systolic strain, can correlate with PVC-based LV SWI and CPI in an ovine model of cardiogenic shock undergoing VA ECMO