{"id":{"repo_id":"umn","oai_identifier":"oai:conservancy.umn.edu:11299/219279"},"canonical_url":"https://search.dev.ndltd.org/etd/umn/oai:conservancy.umn.edu:11299/219279","repository":{"repo_id":"umn","name":"University of Minnesota","base_url":"https://conservancy.umn.edu/server/oai/request"},"display":{"title":"Echocardiographic Evaluation of Left Ventricular Recovery After Refractory Out-of-Hospital Cardiac Arrest","abstract":"Background: The mechanisms and degree of myocardial recovery during treatment with venoarterial extracorporeal membrane oxygenation (VA-ECMO) are unclear. We performed a descriptive study to evaluate myocardial recovery and changes in parameters of myocardial loading using echocardiography. Methods: We used a retrospective cohort design to evaluate patients with refractory ventricular tachycardia/ventricular fibrillation out-of-hospital cardiac arrest who were treated with the Minnesota Resuscitation Consortium protocol. Left ventricular ejection fraction (LVEF), end-diastolic diameter (LVEDD), end-systolic diameter (LVESD), and fractional shortening were assessed using serial echocardiography. One-way analysis of variance (ANOVA) was used to compare parameters over six hospitalization stages. Two-way ANOVA was used to compare these parameters between patients that died during the index hospitalization and patients that survived. Results: 77 patients had >1 echocardiographic turndown evaluations. Thirty-eight patients survived to discharge and 39 patients died. Of 39 in-hospital deaths, 17 patients died before VA-ECMO decannulation and 22 patients died after VA-ECMO decannulation. Among all patients, LVEF improved from 9.7±10.1% from the first echocardiogram after rewarming to 43.1±13.1% after decannulation (p<0.001) and fractional shortening ratio improved from 0.14±0.12 to 0.31±0.14 (p<0.001). The LVEDD and LVESD remained stable (p=0.36 and p=0.12, respectively). Patients that died had a lower LVEF by an average of 6.93% (95% confidence interval: -10.0 to -3.83, p<0.001), but other parameters were similar. Conclusion: Refractory cardiac arrest patients treated with VA-ECMO experience significant recovery of ventricular function during treatment. We postulate that this primarily occurs via reduction of LV preload.","abstract_html":"Background: The mechanisms and degree of myocardial recovery during treatment with venoarterial extracorporeal membrane oxygenation (VA-ECMO) are unclear. We performed a descriptive study to evaluate myocardial recovery and changes in parameters of myocardial loading using echocardiography. Methods: We used a retrospective cohort design to evaluate patients with refractory ventricular tachycardia/ventricular fibrillation out-of-hospital cardiac arrest who were treated with the Minnesota Resuscitation Consortium protocol. Left ventricular ejection fraction (LVEF), end-diastolic diameter (LVEDD), end-systolic diameter (LVESD), and fractional shortening were assessed using serial echocardiography. One-way analysis of variance (ANOVA) was used to compare parameters over six hospitalization stages. Two-way ANOVA was used to compare these parameters between patients that died during the index hospitalization and patients that survived. Results: 77 patients had &gt;1 echocardiographic turndown evaluations. Thirty-eight patients survived to discharge and 39 patients died. Of 39 in-hospital deaths, 17 patients died before VA-ECMO decannulation and 22 patients died after VA-ECMO decannulation. Among all patients, LVEF improved from 9.7±10.1% from the first echocardiogram after rewarming to 43.1±13.1% after decannulation (p&lt;0.001) and fractional shortening ratio improved from 0.14±0.12 to 0.31±0.14 (p&lt;0.001). The LVEDD and LVESD remained stable (p=0.36 and p=0.12, respectively). Patients that died had a lower LVEF by an average of 6.93% (95% confidence interval: -10.0 to -3.83, p&lt;0.001), but other parameters were similar. Conclusion: Refractory cardiac arrest patients treated with VA-ECMO experience significant recovery of ventricular function during treatment. We postulate that this primarily occurs via reduction of LV preload.","abstract_has_math":false,"creators":["Kalra, Rajat"],"institution":null,"degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":[],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2020,"date_issued":"2020-12","date_published":"2020-12","updated_at":"2026-07-24T05:19:56Z","subjects":["Cardiac arrest","Echocardiography","Heart failure"],"languages":["en"],"rights":[],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"https://hdl.handle.net/11299/219279","outbound_label":"Handle","outbound_source":"dc:identifier.uri"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:creator","label":"Author","values":["Kalra, Rajat"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.accessioned","label":"Dc Date Accessioned","values":["2021-04-12T21:04:00Z"]},{"key":"dc:date.available","label":"Dc Date Available","values":["2021-04-12T21:04:00Z"]},{"key":"dc:date.issued","label":"Date","values":["2020-12"]},{"key":"dc:type","label":"Dc Type","values":["Thesis or Dissertation"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["Cardiac arrest","Echocardiography","Heart failure"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language.iso","label":"Language (ISO)","values":["en"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier.uri","label":"Identifier URI","values":["https://hdl.handle.net/11299/219279"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description","label":"Description","values":["University of Minnesota M.S. thesis. 2020. Major: Clinical Research. Advisor: Demetris Yannopoulos. 1 computer file (PDF); 57 pages."]},{"key":"dc:description.abstract","label":"Abstract","values":["Background: The mechanisms and degree of myocardial recovery during treatment with venoarterial extracorporeal membrane oxygenation (VA-ECMO) are unclear. We performed a descriptive study to evaluate myocardial recovery and changes in parameters of myocardial loading using echocardiography. Methods: We used a retrospective cohort design to evaluate patients with refractory ventricular tachycardia/ventricular fibrillation out-of-hospital cardiac arrest who were treated with the Minnesota Resuscitation Consortium protocol. Left ventricular ejection fraction (LVEF), end-diastolic diameter (LVEDD), end-systolic diameter (LVESD), and fractional shortening were assessed using serial echocardiography. One-way analysis of variance (ANOVA) was used to compare parameters over six hospitalization stages. Two-way ANOVA was used to compare these parameters between patients that died during the index hospitalization and patients that survived. Results: 77 patients had >1 echocardiographic turndown evaluations. Thirty-eight patients survived to discharge and 39 patients died. Of 39 in-hospital deaths, 17 patients died before VA-ECMO decannulation and 22 patients died after VA-ECMO decannulation. Among all patients, LVEF improved from 9.7±10.1% from the first echocardiogram after rewarming to 43.1±13.1% after decannulation (p<0.001) and fractional shortening ratio improved from 0.14±0.12 to 0.31±0.14 (p<0.001). The LVEDD and LVESD remained stable (p=0.36 and p=0.12, respectively). Patients that died had a lower LVEF by an average of 6.93% (95% confidence interval: -10.0 to -3.83, p<0.001), but other parameters were similar. Conclusion: Refractory cardiac arrest patients treated with VA-ECMO experience significant recovery of ventricular function during treatment. We postulate that this primarily occurs via reduction of LV preload."]},{"key":"dc:title","label":"Title","values":["Echocardiographic Evaluation of Left Ventricular Recovery After Refractory Out-of-Hospital Cardiac Arrest"]}]}],"canonical_facts":{"dc:creator":["Kalra, Rajat"],"dc:date.accessioned":["2021-04-12T21:04:00Z"],"dc:date.available":["2021-04-12T21:04:00Z"],"dc:date.issued":["2020-12"],"dc:description":["University of Minnesota M.S. thesis. 2020. Major: Clinical Research. Advisor: Demetris Yannopoulos. 1 computer file (PDF); 57 pages."],"dc:description.abstract":["Background: The mechanisms and degree of myocardial recovery during treatment with venoarterial extracorporeal membrane oxygenation (VA-ECMO) are unclear. We performed a descriptive study to evaluate myocardial recovery and changes in parameters of myocardial loading using echocardiography. Methods: We used a retrospective cohort design to evaluate patients with refractory ventricular tachycardia/ventricular fibrillation out-of-hospital cardiac arrest who were treated with the Minnesota Resuscitation Consortium protocol. Left ventricular ejection fraction (LVEF), end-diastolic diameter (LVEDD), end-systolic diameter (LVESD), and fractional shortening were assessed using serial echocardiography. One-way analysis of variance (ANOVA) was used to compare parameters over six hospitalization stages. Two-way ANOVA was used to compare these parameters between patients that died during the index hospitalization and patients that survived. Results: 77 patients had >1 echocardiographic turndown evaluations. Thirty-eight patients survived to discharge and 39 patients died. Of 39 in-hospital deaths, 17 patients died before VA-ECMO decannulation and 22 patients died after VA-ECMO decannulation. Among all patients, LVEF improved from 9.7±10.1% from the first echocardiogram after rewarming to 43.1±13.1% after decannulation (p<0.001) and fractional shortening ratio improved from 0.14±0.12 to 0.31±0.14 (p<0.001). The LVEDD and LVESD remained stable (p=0.36 and p=0.12, respectively). Patients that died had a lower LVEF by an average of 6.93% (95% confidence interval: -10.0 to -3.83, p<0.001), but other parameters were similar. Conclusion: Refractory cardiac arrest patients treated with VA-ECMO experience significant recovery of ventricular function during treatment. We postulate that this primarily occurs via reduction of LV preload."],"dc:identifier.uri":["https://hdl.handle.net/11299/219279"],"dc:language.iso":["en"],"dc:subject":["Cardiac arrest","Echocardiography","Heart failure"],"dc:title":["Echocardiographic Evaluation of Left Ventricular Recovery After Refractory Out-of-Hospital Cardiac Arrest"],"dc:type":["Thesis or Dissertation"]},"updated_at":"2026-07-24T05:19:56Z"}