Echocardiographic surrogate of left ventricular stroke work in a model of brain stem death donors

Sato K, See Hoe L, Chan J, Obonyo NG, Wildi K, Heinsar S, Colombo SM, Ainola C, Abbate G, Sato N, Passmore MR, Bouquet M, Wilson ES, Hyslop K, Livingstone S, Haymet A, Jung JS, Skeggs K, Palmieri C, White N, Platts D, Suen JY, McGiffin DC, Bassi GL, Fraser JF Eur J Clin Invest DOI 10.1111/eci.14259

Background: The 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.