Echocardiographic Evidence of Cardiac Atrophy in the Critically Ill. (18th November 2022)

• Record Type: Journal Article
• Authors: Kumaresan, Abirami; Pannu, Ameeka; Mueller, Ariel; De Lima, Andres; Naseem, Heba; O'Connor, Sean P.; Valencia, Juan; Garcia, Daniela; Gosling, Andre Fiche; Talmor, Daniel; Shaefi, Shahzad
• Is Part Of: Critical care explorations. Volume 4:Number 11(2022)
• Page Start: e0804
• Publication Date: 2022-11-18
• Subjects: critical care -- critical illness -- echocardiography -- muscle atrophy -- muscle weakness
• DOI: 10.1097/CCE.0000000000000804
• Languages: English
• ISSNs: 2639-8028

Abstract

Abstract : OBJECTIVES: The purpose of this explorative study is to determine if critically ill patients experience cardiac atrophy that can be quantified as a loss of left ventricular mass (LVM) and thus detected by echocardiography. DESIGN: Retrospective single-center cohort study. SETTING: Patients admitted to a tertiary medical center in Boston, MA. PATIENTS: Adult critically ill patients with ICU length of stay greater than or equal to 5 days. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We conducted a retrospective cohort study of 68 patients, of which 42 were included in the final analysis (mean age 60.9 ± 19.2 yr; 47.6% male). The median length of ICU stay was 11.3 days (interquartile range, 6.8–20.1 d). A decrease in mean LVM over the course of admission for critical illness was observed (median 189.11 g [162.82–240.20 g] vs 176.69 g [142.37–226.26 g]; p = 0.01). After adjusting for sex, age, fluid balance, ICU type, dietary orders, time between echocardiograms, and vasopressor use, this decrease in LVM remained consistent (mean difference, –21.30 g; 95% CI, –41.85 to –0.74; p = 0.04). Relative wall thickness (RWT) did not change during admission. CONCLUSIONS: These data reveal that a loss of LVM is present in patients over their ICU stay without a corresponding change in RWT, consistent with cardiac atrophy. Future prospective studies are needed to confirm these findings and identify possible sequelae of this finding.