TY - JOUR
T1 - Long-term heart function in cardiac-arrest survivors
AU - Raphalen, Jean Herlé
AU - Soumagnac, Tal
AU - Delord, Marc
AU - Bougouin, Wulfran
AU - Georges, Jean Louis
AU - Paul, Marine
AU - Legriel, Stéphane
N1 - Funding Information:
The study was supported by the French public funding agency Délégation à la Recherche Clinique et à l’Innovation (DRCI), Versailles, France.
Funding Information:
We are grateful to the following for their contribution to the study: Alexis Ferré, Antoine Gros, Guillaume Lacave, Virginie Laurent, Gilles Troché, Fabrice Bruneel, Jean-Pierre Bédos, Hugo Bellut, Maris Salvetti, and Florence Sarfati (Intensive Care Unit, Versailles Hospital, Le Chesnay, France); Fabien Marquion (Anesthesiology Department, Versailles Hospital, Le Chesnay, France); Anaïs Codorniu (Anesthesiology and Critical Care Department, Beaujon Hospital, Clichy, France); and Anne Roche (Respiratory and Intensive Care Medicine Department, Bicêtre Hospital, Le Kremlin-Bicêtre, France). All procedures involving the patients complied with the ethical standards of the institutional and national research committees and with the 1964 Declaration of Helsinki and its later amendments. In keeping with French law on retrospective analyses of deidentified health data, informed consent was not required for this study. The study database was reported to the data protection authority (Commission Nationals de l'Informatique et des Libertés, #xxxx). The study was supported by the French public funding agency Délégation à la Recherche Clinique et à l'Innovation (DRCI), Versailles, France. The funder and sponsor had no part in the collection, management, analysis, or interpretation of the data; manuscript writing; or decision to submit the manuscript for publication.
Publisher Copyright:
© 2023 The Author(s)
PY - 2023/12
Y1 - 2023/12
N2 - Purpose: To assess outcomes and predictors of long-term myocardial dysfunction after cardiac arrest (CA) of cardiac origin. Methods: We retrospectively included consecutive, single-center, prospective-registry patients who survived to hospital discharge for adult out-of-hospital and in-hospital CA of cardiac origin in 2005–2019. The primary objective was to collect the 1-year New York Heart Association Functional Class (NYHA-FC) and major adverse cardiovascular events (MACE). Results: Of 135 patients, 94 (72%) had their NYHA-FC determined after 1 year, including 75 (75/94, 80%) who were I, 17 (17/94, 18%) II, 2 (2/94, 2%) III, and none IV. The echocardiographic left ventricular ejection fraction was abnormal in 87/130 (67%) patients on day 1, 52/123 (42%) at hospital discharge, and 17/52 (33%) at 6 months. During the median follow-up of 796 [283–1975] days, 38/119 (32%) patients experienced a MACE. These events were predominantly related to acute heart failure (13/38) or ischemic cardiovascular events (16/38), with acute coronary syndrome being the most prevalent among them (8/16). Pre-CA cardiovascular disease was a risk factor for 1-year NYHA-FC > I (P = 0.01), absence of bystander cardiopulmonary resuscitation was significantly associated with NYHA-FC > I at 1 year. Conclusion: Most patients had no heart-failure symptoms a year after adult out-of hospital or in-hospital CA of cardiac origin, and absence of bystander cardiopulmonary resuscitation was the only treatment component significantly associated with NYHA-FC > I at 1 year. Nearly a third experienced MACE and the most common types of MACE were ischemic cardiovascular events and acute heart failure. Early left ventricular dysfunction recovered within 6 months in half the patients with available values.
AB - Purpose: To assess outcomes and predictors of long-term myocardial dysfunction after cardiac arrest (CA) of cardiac origin. Methods: We retrospectively included consecutive, single-center, prospective-registry patients who survived to hospital discharge for adult out-of-hospital and in-hospital CA of cardiac origin in 2005–2019. The primary objective was to collect the 1-year New York Heart Association Functional Class (NYHA-FC) and major adverse cardiovascular events (MACE). Results: Of 135 patients, 94 (72%) had their NYHA-FC determined after 1 year, including 75 (75/94, 80%) who were I, 17 (17/94, 18%) II, 2 (2/94, 2%) III, and none IV. The echocardiographic left ventricular ejection fraction was abnormal in 87/130 (67%) patients on day 1, 52/123 (42%) at hospital discharge, and 17/52 (33%) at 6 months. During the median follow-up of 796 [283–1975] days, 38/119 (32%) patients experienced a MACE. These events were predominantly related to acute heart failure (13/38) or ischemic cardiovascular events (16/38), with acute coronary syndrome being the most prevalent among them (8/16). Pre-CA cardiovascular disease was a risk factor for 1-year NYHA-FC > I (P = 0.01), absence of bystander cardiopulmonary resuscitation was significantly associated with NYHA-FC > I at 1 year. Conclusion: Most patients had no heart-failure symptoms a year after adult out-of hospital or in-hospital CA of cardiac origin, and absence of bystander cardiopulmonary resuscitation was the only treatment component significantly associated with NYHA-FC > I at 1 year. Nearly a third experienced MACE and the most common types of MACE were ischemic cardiovascular events and acute heart failure. Early left ventricular dysfunction recovered within 6 months in half the patients with available values.
KW - Cardiac arrest
KW - Cardio-pulmonary resuscitation
KW - Heart failure
KW - Prognostic factors
KW - Ventricular ejection fraction
UR - http://www.scopus.com/inward/record.url?scp=85174032808&partnerID=8YFLogxK
U2 - 10.1016/j.resplu.2023.100481
DO - 10.1016/j.resplu.2023.100481
M3 - Article
AN - SCOPUS:85174032808
SN - 2666-5204
VL - 16
JO - RESUSCITATION PLUS
JF - RESUSCITATION PLUS
M1 - 100481
ER -
