Two-Dimensional Strain Rate and Doppler Tissue Myocardial Velocities: Analysis by Echocardiography of Hemodynamic and Functional Changes of the Failed Left Ventricle during Different Degrees of Extracorporeal Life Support

详细信息	查看全文 | 推荐本文 |

• 作者：Nadia Aissaoui ; MD^a ; ^b ; ^c ; ^{nadia.aissaoui@sat.aphp.fr} ; Emmanuel Guerot ; MD^a ; ^b ; Alain Combes ; MD ; PhD^d ; Annie Delouche ; RN^c ; Jean Chastre ; MD ; PhD^d ; Pascal Leprince ; MD ; PhD^d ; Philippe Leger ; MD^d ; Jean Luc Diehl ; MD ; PhD^a ; ^b ; Jean Yves Fagon ; MD ; PhD^b ; Benoit Diebold ; MD ; PhD^a ; ^b ; ^c
• 关键词：Load dependence ; Strain rate ; Velocity Vector Imaging ; Extracorporeal life support ; Failed ventricle ; Tissue Doppler velocities
• 刊名：Journal of the American Society of Echocardiography
• 出版年：2012
• 期刊代码：pca202_08947317
• 类别：med
• 出版时间：June, 2012
• 卷：25
• 期：6
• 页码：632-640
• 文件大小：733 K

摘要

| Figures/TablesFigures/Tables | ReferencesReferences

Background

To evaluate hemodynamic and functional changes of the failed left ventricle by Velocity Vector Imaging (VVI) and tissue Doppler, 22 patients with cardiogenic shock supported by extracorporeal life support (ECLS) were imaged during ECLS output variations inducing severe load manipulations.

Methods

The following data were acquired: (1) mean arterial pressure, aortic Doppler velocity-time integral, left ventricular end-diastolic volume, and mitral Doppler E wave; (2) tissue Doppler systolic (Sa) and early diastolic (Ea) velocities; and (3) systolic peak velocity (Sv), strain, and strain rate using VVI.

Results

Load variations were documented by a significant decrease in afterload (mean arterial pressure, 鈭?1%), an increase in preload (left ventricular end-diastolic volume,聽+12%; E,聽+46%; E/Ea ratio,聽+22%), and an increase in the velocity-time integral (+45%). VVI parameters increased (Sv,聽+36%; strain,聽+81%; and strain rate,聽+67%; P < .05), unlike tissue Doppler systolic velocities (+2%; P聽= NS). Whatever the ECLS flow, Sa was higher in patients who survived.

Conclusions

VVI parameters are not useful in characterizing the failed left ventricle with rapidly varying load conditions. Tissue Doppler systolic velocities appear to be load independent and thus could help in the management of ECLS patients.