ArticleResuscitation2021
Quantitative characterization of left ventricular function during pulseless electrical activity using echocardiography during out-of-hospital cardiac arrest.
Article in Resuscitation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 18 citations in OpenAlex.
- Point-of-Care Ultrasound M-Mode Analysis Using M.mode.ify: An External Validation Study for E-point Septal Separation Measurement.Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine · 2026Article
- Intra-arrest TEE and the unresolved physiology of effective CPR.Resuscitation · 2026Article
- Inter-rater reliability of point-of-care ultrasound during out-of-hospital cardiac arrest: an ancillary analysis of the observational prospective ACE trial.Resuscitation plus · 2026Article
- State-transition trajectories in out-of-hospital cardiac arrest: neurological outcomes beyond myocardial activity.Critical care (London, England) · 2025Article
- PEA: seeing what the rhythm doesn't say.Critical care (London, England) · 2025Article
- Development and Implementation of a Multicenter Registry for Resuscitation-Focused Transesophageal Echocardiography.Annals of emergency medicine · 2025Observational
- Ultrasound during Advanced Life Support-Help or Harm?Diagnostics (Basel, Switzerland) · 2024Article
- Determinants of survival in sudden cardiac arrest manifesting with pulseless electrical activity.Resuscitation · 2023Article
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Authors and funding
21 authors at 11 institutions in 2 countries.
Funding
Abstract
backgroundSeveral prospective studies have demonstrated that the echocardiographic detection of any myocardial activity during PEA is strongly associated with higher rates of return of spontaneous circulation (ROSC). We hypothesized that PEA represents a spectrum of disease in which not only the presence of myocardial activity, but more specifically that the degree of left ventricular (LV) function would be a predictor of outcomes. The purpose of this study was to retrospectively assess the association between LV function and outcomes in patients with OHCA. MATERIALS AND
methodsUsing prospectively obtained data from an observational cohort of patients receiving focused echocardiography during cardiopulmonary resuscitation (CPR) in the Emergency Department (ED) setting, we analyzed 312 consecutive subjects with available echocardiography images with initial rhythm of PEA. We used left ventricular systolic fractional shortening (LVFS), a unidimensional echocardiographic parameter to perform the quantification of LV function during PEA. Regression analyses were performed independently to evaluate for relationships between LVFS and a primary outcome of ROSC and secondary outcome of survival to hospital admission. We analyzed LVFS both as a continuous variable and as a categorial variable using the quartiles and the median to perform multiple different comparisons and to illustrate the relationship of LVFS and outcomes of interest. We performed survival analysis using Cox proportional hazards model to evaluate the hazard corresponding to length of resuscitation.
resultsWe found a positive association between LVFS and the primary outcome of ROSC (OR 1.04, 95%CI 1.01-1.08), but not with the secondary outcome of survival to hospital admission (OR 1.02, 95%CI 0.96-1.08). Given that the relationship was not linear and that we observed a threshold effect in the relationship between LVFS and outcomes, we performed an analysis using quartiles of LVFS. The predicted probability of ROSC was 75% for LVFS between 23.4-96% (fourth quartile) compared to 47% for LVFS between 0-4.7% (first quartile). The hazard of not achieving ROSC was significantly greater for subjects with LVFS below the median (13.1%) compared to the subgroup with LVFS greater than 13.1% (p < 0.05), with the separation of the survival curves occurring at approximately 40 min of resuscitation duration.
conclusionsLeft ventricular function measured by LVFS is positively correlated with higher probability of ROSC and may be associated with higher chances of survival in patients with PEA arrest.
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