Effect of Prolonged Targeted Temperature Management on Left Ventricular Myocardial Function after Out-of-Hospital Cardiac Arrest - A Randomised, Controlled Trial

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@article{8438f14ae1d54473a9565edc4ae940ee,
title = "Effect of Prolonged Targeted Temperature Management on Left Ventricular Myocardial Function after Out-of-Hospital Cardiac Arrest - A Randomised, Controlled Trial",
abstract = "AIM: To evaluate post-cardiac arrest myocardial dysfunction during prolonged targeted temperature management (TTM) compared with standard TTM in comatose out-of-hospital cardiac arrest (OHCA) survivors.METHODS: A randomised, controlled trial comparing myocardial function after TTM at 33 ±1°C for 48h compared with 24h. A total of 105 OHCA patients were computer-randomised to 24h (n=50) or 48h (n=55) of TTM. Transthoracic echocardiography was performed after 24h, 48h and 72h. Echocardiographic parameters were evaluated by an investigator who was blinded to randomisation. The primary endpoint was peak systolic mitral annular velocity (Ś) measured as the difference in the period from 24h to 72h. The model was adjusted for age, primary rhythm and heart rate. The secondary outcomes were global peak longitudinal strain, left ventricular ejection fraction (LVEF), tricuspid annular plane systolic excursion (TAPSE) and the diastolic measures e' and E/e'.RESULTS: The mean difference of S' was significantly increased in the 48h group compared with the 24h group: -1.14cm/sec (-1.83; -0.45), p=0.001. This difference was consistent after adjusting the data (p=0.008). However, there were no significant changes between the study groups with respect to the adjusted secondary outcomes of global peak longitudinal strain (p=0.07), LVEF (p=0.31), TAPSE (p=0.91), e' (p=0.26) and E/e' (p=0.18).CONCLUSION: Prolonged TTM at 33°C of 48h compared with 24h in comatose OHCA survivors may improve the recovery of post-cardiac arrest left myocardial dysfunction demonstrated by the echocardiographic outcome, S'. ClinicalTrials.gov identifier: NCT02066753.",
keywords = "Journal Article",
author = "Grejs, {Anders Morten} and Nielsen, {Bent Roni Rangh{\o}j} and Peter Juhl-Olsen and Jakob Gjedsted and Erik Sloth and Johan Heiberg and Frederiksen, {Christian Alcaraz} and Jeppesen, {Anni N{\o}rgaard} and Duez, {Christophe Henri Valdemar} and Hamre, {Per Dreyer} and Eldar S{\o}reide and Hans Kirkegaard",
note = "Copyright {\circledC} 2017 Elsevier B.V. All rights reserved.",
year = "2017",
month = "6",
doi = "10.1016/j.resuscitation.2017.03.021",
language = "English",
volume = "115",
journal = "Resuscitation",
issn = "0300-9572",
publisher = "Elsevier Ireland Ltd.",

}

RIS

TY - JOUR

T1 - Effect of Prolonged Targeted Temperature Management on Left Ventricular Myocardial Function after Out-of-Hospital Cardiac Arrest - A Randomised, Controlled Trial

AU - Grejs, Anders Morten

AU - Nielsen, Bent Roni Ranghøj

AU - Juhl-Olsen, Peter

AU - Gjedsted, Jakob

AU - Sloth, Erik

AU - Heiberg, Johan

AU - Frederiksen, Christian Alcaraz

AU - Jeppesen, Anni Nørgaard

AU - Duez, Christophe Henri Valdemar

AU - Hamre, Per Dreyer

AU - Søreide, Eldar

AU - Kirkegaard, Hans

N1 - Copyright © 2017 Elsevier B.V. All rights reserved.

PY - 2017/6

Y1 - 2017/6

N2 - AIM: To evaluate post-cardiac arrest myocardial dysfunction during prolonged targeted temperature management (TTM) compared with standard TTM in comatose out-of-hospital cardiac arrest (OHCA) survivors.METHODS: A randomised, controlled trial comparing myocardial function after TTM at 33 ±1°C for 48h compared with 24h. A total of 105 OHCA patients were computer-randomised to 24h (n=50) or 48h (n=55) of TTM. Transthoracic echocardiography was performed after 24h, 48h and 72h. Echocardiographic parameters were evaluated by an investigator who was blinded to randomisation. The primary endpoint was peak systolic mitral annular velocity (Ś) measured as the difference in the period from 24h to 72h. The model was adjusted for age, primary rhythm and heart rate. The secondary outcomes were global peak longitudinal strain, left ventricular ejection fraction (LVEF), tricuspid annular plane systolic excursion (TAPSE) and the diastolic measures e' and E/e'.RESULTS: The mean difference of S' was significantly increased in the 48h group compared with the 24h group: -1.14cm/sec (-1.83; -0.45), p=0.001. This difference was consistent after adjusting the data (p=0.008). However, there were no significant changes between the study groups with respect to the adjusted secondary outcomes of global peak longitudinal strain (p=0.07), LVEF (p=0.31), TAPSE (p=0.91), e' (p=0.26) and E/e' (p=0.18).CONCLUSION: Prolonged TTM at 33°C of 48h compared with 24h in comatose OHCA survivors may improve the recovery of post-cardiac arrest left myocardial dysfunction demonstrated by the echocardiographic outcome, S'. ClinicalTrials.gov identifier: NCT02066753.

AB - AIM: To evaluate post-cardiac arrest myocardial dysfunction during prolonged targeted temperature management (TTM) compared with standard TTM in comatose out-of-hospital cardiac arrest (OHCA) survivors.METHODS: A randomised, controlled trial comparing myocardial function after TTM at 33 ±1°C for 48h compared with 24h. A total of 105 OHCA patients were computer-randomised to 24h (n=50) or 48h (n=55) of TTM. Transthoracic echocardiography was performed after 24h, 48h and 72h. Echocardiographic parameters were evaluated by an investigator who was blinded to randomisation. The primary endpoint was peak systolic mitral annular velocity (Ś) measured as the difference in the period from 24h to 72h. The model was adjusted for age, primary rhythm and heart rate. The secondary outcomes were global peak longitudinal strain, left ventricular ejection fraction (LVEF), tricuspid annular plane systolic excursion (TAPSE) and the diastolic measures e' and E/e'.RESULTS: The mean difference of S' was significantly increased in the 48h group compared with the 24h group: -1.14cm/sec (-1.83; -0.45), p=0.001. This difference was consistent after adjusting the data (p=0.008). However, there were no significant changes between the study groups with respect to the adjusted secondary outcomes of global peak longitudinal strain (p=0.07), LVEF (p=0.31), TAPSE (p=0.91), e' (p=0.26) and E/e' (p=0.18).CONCLUSION: Prolonged TTM at 33°C of 48h compared with 24h in comatose OHCA survivors may improve the recovery of post-cardiac arrest left myocardial dysfunction demonstrated by the echocardiographic outcome, S'. ClinicalTrials.gov identifier: NCT02066753.

KW - Journal Article

U2 - 10.1016/j.resuscitation.2017.03.021

DO - 10.1016/j.resuscitation.2017.03.021

M3 - Journal article

VL - 115

JO - Resuscitation

JF - Resuscitation

SN - 0300-9572

ER -