The Role of LVOT-VTI Measurement in the Evaluation of Systolic Heart Function in Pulmonary ICU Patients

Abstract

\n\nThe detection of cardiac systolic dysfunction is very important for well\nmanagement of pulmonary critical care patients (PCCPs). However, there is a poor correlation between\nechocardiographic cardiac systolic function (CSF) parameters and it is not easy to obtain these\nparameters in PCCPs. Therefore, this cross-sectional observational study was planned for the\ndetection of a more easily obtainable echocardiographic CSF parameter that is well correlated with\nother CSF parameters in PCCPs.\n\n\n\nTotal 88 PCCPs were included. Demographic and clinical information\nand laboratory tests of all patients were recorded. The CSF parameters of the heart were obtained\nby transthoracic echocardiography with appropriate technique. LVOT-VTI (Left ventricular outflow\ntract velocity time integral), CO (cardiac output), EPSS (e point septal separation), Left ventricular\nEF (ejection fraction) and TAPSE (Tricuspid Annular Plane Systolic Excursion) as an indicator\nof CSF were tried to obtain from all patients. We also calculated sensitivity, specificity, positive\nand negative predictive values of LVOT-VTI<20 parameters to diagnose heart failure.\n\n\n\nThe mean age of the patients was 73±12, 40% were female, 38% were intubated and 52%\nhad COPD. LVOT-VTI, EF, CO, EPSS parameters were obtained in 54(61%), 24(27%), 48(54%),\n48(54%) patients, respectively. Decreased LVOT-VTI (<20 cm) was well correlated with decreased\nEF (<45%) (p=0.001, r=0.77), decreased CO (<5 L/dk) (p=0.03, r=0.64) and decreased\nTAPSE (<17 mm) (p=0.001, r=0.71). Also, there was good agreement between the EF and LVOTVTI\nmeasurements (Kappa:0.78, p:0.001). Sensitivity, specificity, positive and negative predictive\nvalues of LVOT-VTI<20 for heart failure were 58, 78, 84, 49, repectively.\n\n\n\nLVOT-VTI is a more easily obtainable and well correlated parameter, which can be\nused as an indicator of CSF in PCCPs.\n\n\n\nThe authors believe that LVOT-VTI measurement has good correlation\nwith other echocardiographic systolic function parameters, and its easy measurement in intensive\ncare patients makes it a very useful test for cardiac systolic function evaluation.\n