Echocardiographic surrogate of left ventricular stroke work in a model of brain stem death donors

Kei Sato,Kei Sato,Jae‐Seung Jung,Gianluigi Li Bassi,David C Mcgiffin,Nicole White,Noriko Sato,Gianluigi Li Bassi,Kris Skeggs,Margaret R Passmore,Nicole White,David Platts,Jacky Y Suen,Louise See Hoe,Samantha Livingstone,Louise See Hoe,Silver Heinsar,Kris Skeggs,Karin Wildi,Jacky Y Suen,David C Mcgiffin,Samantha Livingstone,Gianluigi Li Bassi,Jae‐Seung Jung,Jae‐Seung Jung,Kris Skeggs,Jacky Y Suen,Nchafatso G Obonyo,Gianluigi Li Bassi,John F Fraser,Sebastiano M Colombo,Jacky Y Suen,Gianluigi Li Bassi,Nchafatso G Obonyo,Nchafatso G Obonyo,Nchafatso G Obonyo,Nchafatso G Obonyo,Nchafatso G Obonyo,Sebastiano M Colombo,Jacky Y Suen,Jae‐Seung Jung,Jae‐Seung Jung,Louise See Hoe,Emily S Wilson,Jae‐Seung Jung,Karin Wildi,Carmen Ainola,Emily S Wilson,David C Mcgiffin,Kris Skeggs,Nchafatso G Obonyo,Nchafatso G Obonyo,Kieran Hyslop,Sebastiano M Colombo,Louise See Hoe,Gianluigi Li Bassi,Jacky Y Suen,Jonathan Chan,Samantha Livingstone,Jae‐Seung Jung,Gianluigi Li Bassi,Mahe Bouquet,Nchafatso G Obonyo,Gianluigi Li Bassi,Jacky Y Suen,Gianluigi Li Bassi,Sebastiano M Colombo,Nchafatso G Obonyo,Jacky Y Suen,Silver Heinsar,Gianluigi Li Bassi,Emily S Wilson,Silver Heinsar,Nchafatso G Obonyo,Nchafatso G Obonyo,Andrew Haymet,John F Fraser,David C Mcgiffin,Nchafatso G Obonyo,Gianluigi Li Bassi,Gabriella Abbate,David C Mcgiffin,Jae‐Seung Jung,Sebastiano M Colombo,John F Fraser,Kieran Hyslop,Margaret R Passmore,Gianluigi Li Bassi,David Platts,Karin Wildi,Sebastiano M Colombo,Jonathan Chan,Gabriella Abbate,Karin Wildi,Gianluigi Li Bassi,Silver Heinsar,Margaret R Passmore,Louise See Hoe,Sebastiano M Colombo,Kieran Hyslop,Karin Wildi,Silver Heinsar,Nicole White,Chiara Palmieri,Karin Wildi,Louise See Hoe,Noriko Sato,David C Mcgiffin,David C Mcgiffin,Silver Heinsar,Louise See Hoe,Nchafatso G Obonyo,Gabriella Abbate,David Platts,Louise See Hoe,Nicole White,Mahe Bouquet,John F Fraser,Karin Wildi,Gabriella Abbate,Noriko Sato,Emily S Wilson,Gianluigi Li Bassi,Andrew Haymet,Jonathan Chan,Silver Heinsar,Karin Wildi,David Platts,Andrew Haymet,Margaret R Passmore,Jacky Y Suen,Sebastiano M Colombo,Silver Heinsar,Nchafatso G Obonyo,Karin Wildi,Nchafatso G Obonyo,Carmen Ainola,Mahe Bouquet,Andrew Haymet,Jonathan Chan,Sebastiano M Colombo,Gianluigi Li Bassi,Gianluigi Li Bassi,Mahe Bouquet,Noriko Sato,Kieran Hyslop,David C Mcgiffin,Jae‐Seung Jung,Carmen Ainola,Silver Heinsar,Louise See Hoe,David C Mcgiffin,Samantha Livingstone,Carmen Ainola

doi:10.1111/eci.14259

Abstract

AbstractBackgroundThe commonest echocardiographic measurement, left ventricular ejection fraction, can not necessarily predict mortality of recipients following heart transplantation potentially due to afterload dependency. Afterload‐independent left ventricular stroke work index (LVSWI) is alternatively recommended by the current guideline; however, pulmonary artery catheters are rarely inserted in organ donors in most jurisdictions. We propose a novel non‐invasive echocardiographic parameter, Pressure‐Strain Product (PSP), as a potential surrogate of catheter‐based LVSWI. This study aimed to investigate if PSP could correlate with catheter‐based LVSWI in an ovine model of brain stem death (BSD) donors. The association between PSP and myocardial mitochondrial function in the post‐transplant hearts was also evaluated.MethodsThirty‐one female sheep (weight 47 ± 5 kg) were divided into two groups; BSD (n = 15), and sham neurologic injury (n = 16). Echocardiographic parameters including global circumferential strain (GCS) and global radial strain (GRS) and pulmonary artery catheter‐based LVSWI were simultaneously measured at 8‐timepoints during 24‐h observation. PSP was calculated as a product of GCS or GRS, and mean arterial pressure for PSPcirc or PSPrad, respectively. Myocardial mitochondrial function was evaluated following 6‐h observation after heart transplantation.ResultsIn BSD donor hearts, PSPcirc (n = 96, rho = .547, p < .001) showed the best correlation with LVSWI among other echocardiographic parameters. PSPcirc returned AUC of .825 to distinguish higher values of cardiomyocyte mitochondrial function (cut‐off point; mean value of complex 1,2 O2 Flux) in post‐transplant hearts, which was greater than other echocardiographic parameters.ConclusionsPSPcirc could be used as a surrogate of catheter‐based LVSWI reflecting mitochondrial function.

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