Title:The Role of LVOT-VTI Measurement in the Evaluation of Systolic Heart Function in Pulmonary ICU Patients
Volume: 16
Issue: 4
Author(s): Meltem Çimen, Selin Eyüboğlu, Uğur Özdemir*, Burhan Sami Kalın, Tuba Güney and Gül Gürsel
Affiliation:
- Division of Critical Care Medicine, Department of Internal Medicine, Gazi University School of Medicine, Ankara,Turkey
Keywords:
COPD, LVOT-VTI, systolic dysfunction, transthoracic echocardiography, ICU, respiratory failure.
Abstract:
Introduction: The detection of cardiac systolic dysfunction is very important for well
management of pulmonary critical care patients (PCCPs). However, there is a poor correlation between
echocardiographic cardiac systolic function (CSF) parameters and it is not easy to obtain these
parameters in PCCPs. Therefore, this cross-sectional observational study was planned for the
detection of a more easily obtainable echocardiographic CSF parameter that is well correlated with
other CSF parameters in PCCPs.
Materials and Methods: Total 88 PCCPs were included. Demographic and clinical information
and laboratory tests of all patients were recorded. The CSF parameters of the heart were obtained
by transthoracic echocardiography with appropriate technique. LVOT-VTI (Left ventricular outflow
tract velocity time integral), CO (cardiac output), EPSS (e point septal separation), Left ventricular
EF (ejection fraction) and TAPSE (Tricuspid Annular Plane Systolic Excursion) as an indicator
of CSF were tried to obtain from all patients. We also calculated sensitivity, specificity, positive
and negative predictive values of LVOT-VTI<20 parameters to diagnose heart failure.
Results: The mean age of the patients was 73±12, 40% were female, 38% were intubated and 52%
had COPD. LVOT-VTI, EF, CO, EPSS parameters were obtained in 54(61%), 24(27%), 48(54%),
48(54%) patients, respectively. Decreased LVOT-VTI (<20 cm) was well correlated with decreased
EF (<45%) (p=0.001, r=0.77), decreased CO (<5 L/dk) (p=0.03, r=0.64) and decreased
TAPSE (<17 mm) (p=0.001, r=0.71). Also, there was good agreement between the EF and LVOTVTI
measurements (Kappa:0.78, p:0.001). Sensitivity, specificity, positive and negative predictive
values of LVOT-VTI<20 for heart failure were 58, 78, 84, 49, repectively.
Conclusion: LVOT-VTI is a more easily obtainable and well correlated parameter, which can be
used as an indicator of CSF in PCCPs.
Clinical Significances: The authors believe that LVOT-VTI measurement has good correlation
with other echocardiographic systolic function parameters, and its easy measurement in intensive
care patients makes it a very useful test for cardiac systolic function evaluation.
