Ventriculo-arterial coupling could be non-invasive prognostic parameter in ICU patients: Study
Rome, Italy: A recent study in the International Journal of Cardiology shows that ventriculo-arterial coupling (VAC) could be an additional non-invasive prognosticator of outcome in ICCU (intensive cardiac care unit) patients.
In the study, Paolo Trambaiolo, ICCU, Sandro Pertini Hospital, Rome, Italy, and the team aimed to investigate the relationship between ventriculo-arterial coupling and in-hospital outcomes and to assess the prognostic value of VAC in critically ill patients.
The researchers included a total of 329 consecutive patients (mean age 66,7 ± 15.5 years, 66.9% male) who were admitted to the intensive cardiac care unit of the Sandro Pertini Hospital, Rome (Italy) between January 2019 and December 2019.
Using the iElastance application, they underwent blood pressure measurement and non-invasive, echocardiography-derived estimates of left ventricular end-systolic elastance (Ees), arterial elastance (Ea), and VAC in a single-beat determination. In-hospital events related to acute heart failure and hypoperfusion were recorded. The need for invasive ventilation, intra-aortic balloon pump, renal replacement therapy, and death was considered as composite.
Key findings include:
- 39 patients (11,8%) experienced in-hospital complications (group C), and 290 (88,2%) did not (group NoC).
- Ea and VAC were found to be significantly higher in group C than in group NoC, and a trend toward decreased Ees was observed in group C.
- VAC was a strong and independent predictor of in-hospital clinical outcome both at univariable and multivariable analysis adjusted for comorbidities and hemodynamic parameters.
"Ventriculo-arterial coupling restoration may have a more relevant impact on prognosis than intrinsic contractility alone, expressed as ventricular elastance or ejection fraction, making uncoupling a reliable risk factor for tissue hypoperfusion," wrote the authors.
"Our findings showed that VAC might be an additional non-invasive prognosticator of outcome in critically ill patients," they concluded.
Reference:
The study titled, "Ventriculo-arterial coupling in the intensive cardiac care unit: A non-invasive prognostic parameter," was published in the International Journal of Cardiology.
