Resuscitation 106 (2016) 58–64 Contents lists available at ScienceDirect Resuscitation jou rn al hom epage : w ww.elsevie r.com/locate/resuscitation Clinical paper Echocardiographic left ventricular systolic dysfunction early after resuscitation from cardiac arrest does not predict mortality or vasopressor requirements  Jacob C. Jentzer a,∗ , Meshe D. Chonde b , Asher Shafton c , Hussein Abu-Daya d , Didier Chalhoub e , Andrew D. Althouse f , Jon C. Rittenberger g a Divisions of Cardiovascular Diseases and Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States b Heart and Vascular Institute, University of Pittsburgh Medical Center, 200 Lothrop Street, Pittsburgh, PA 15211, United States c Heart Institute of Colorado, 1960 Ogden Street Suite 110, Denver, CO 80218, United States d Department of Internal Medicine, University of Pittsburgh Medical Center, 200 Lothrop Street, Pittsburgh, PA 15211, United States e Graduate School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA 15261, United States f Heart and Vascular Institute, University of Pittsburgh Medical Center, 200 Lothrop Street, Pittsburgh, PA 15211, United States g Department of Emergency Medicine, University of Pittsburgh, 3600 Forbes Avenue, Suite 400A, Pittsburgh, PA 15261, United States a r t i c l e i n f o Article history: Received 25 February 2016 Received in revised form 15 June 2016 Accepted 20 June 2016 Keywords: Echocardiography Cardiac arrest Vasopressors Shock Systolic dysfunction a b s t r a c t Background/aims: Echocardiographic abnormalities are common after resuscitation from cardiac arrest. The association between echocardiographic findings with vasopressor requirements and mortality are not well described. We sought to determine the associations between echocardiographic abnormalities and mortality, vasopressor requirements and organ failure after cardiac arrest. Methods: We prospectively evaluated 55 adult subjects undergoing transthoracic echocardiography within 24 h after resuscitation from cardiac arrest. We evaluated the association between 2D echocardi- ographic and Doppler measurements and mortality, Sequential Organ Failure Assessment (SOFA) scores and vasopressor requirements. Results: Inpatient mortality was 60%. Mean left ventricular ejection fraction (LVEF) was 43.6%; LVEF was <40% in 36% of subjects. None of the measured echocardiographic parameters (including LVEF) was signif- icantly associated with inpatient mortality (all p > 0.1). Subjects with LVEF <40% more often had shockable arrest rhythms and patients resuscitated from shockable rhythms had lower mean LVEF (36.2% vs. 52.3%, p = 0.001). There was no correlation between markers of right and left ventricular systolic or diastolic function (including LVEF and Doppler parameters) with vasopressor requirements, lactate levels or SOFA scores. Conclusion: Echocardiographic parameters (including LVEF) were not associated with inpatient mortal- ity after cardiac arrest. Vasopressor requirements and organ failure severity were not associated with multiple echocardiographic markers of systolic function. © 2016 Elsevier Ireland Ltd. All rights reserved. Abbreviations: CVI, umulative vasopressor index; CV, SOFAcardiovascular SOFA subscore; E ′ , early diastolic mitral annular tissue Doppler velocity; E/e ′ , early mitral inflow spectral Doppler to early diastolic mitral annular tissue Doppler velocity ratio; FS, fractional shortening; IHCA, in-hospital cardiac arrest; IS, interventricular septum; LOS, hospital length of stay; LVEDD, left ventricular end-diastolic diameter; LVEF, left ventricular ejection fraction; LVESD, left ventricular end-systolic diameter; LVOT, left ventricular outflow tract; LVSD, left ventricular systolic dysfunction; MI, myocardial infarction; OHCA, out-of-hospital cardiac arrest; PAMD, post-arrest myocardial dysfunction; PCAC, Pittsburgh cardiac arrest category; PCI, percutaneous coronary intervention; PW, posterior wall; RV, right ventricular; RWT, left ventricular relative wall thickness; S ′ , peak systolic mitral annular tissue Doppler velocity; SOFA, sequential organ failure assessment; TAPSE, tricuspid annular plane systolic excursion; TTE, transthoracic echocardiogram; TTM, targeted temperature management; TR, tricuspid regurgitation; Vmax, maximum velocity; VTI, velocity-time integral.  A Spanish translated version of the abstract of this article appears as Appendix in the final online version at http://dx.doi.org/10.1016/j.resuscitation.2016.06.028. ∗ Corresponding author. E-mail addresses: jentzer.jacob@mayo.edu (J.C. Jentzer), chondem@upmc.edu (M.D. Chonde), asher.shafton@sclhs.net (A. Shafton), abudayah@upmc.edu (H. Abu-Daya), didierchalhoub@gmail.com (D. Chalhoub), althousead@upmc.edu (A.D. Althouse), rittjc@upmc.edu (J.C. Rittenberger). http://dx.doi.org/10.1016/j.resuscitation.2016.06.028 0300-9572/© 2016 Elsevier Ireland Ltd. All rights reserved.