The Association of Left and Right Atrial Volume Indices with Survival
Time post-Cardiac Arrest
Abstract
Introduction: Left and right atrial volume indices (LAVI and RAVI) are
markers of cardiac remodeling. LAVI and RAVI are associated with worse
outcomes in other cardiac conditions. This study aimed to determine the
association of LAVI and RAVI with survival time post-cardiac arrest.
Hypothesis: Atrial volumes will be associated with survival time post
cardiac arrest. Methods: This was a single academic center,
retrospective study of patients with a cardiac arrest event during index
hospitalization from 2014-2018. LAVI was calculated using a biplane
Simpson’s method, while RAVI was calculated using a single plane
summation in the 4-chamber view. Patients were further stratified into
either having a Vfib/pulseless VT (pVT) event or a PEA arrest/asystole
event. Survival time was measured in days from event to death date.
Kaplan-Meier plots were used to evaluate differences in survival time
for patients based on mean LAVI and RAVI. Results: Of 305 patients
studied (64 +/- 14 years, 37% female (112 out of 305)), 162 had
reliable LAVI measurements with a mean of 34.1 mL/m2 (SD=15.8) and163
had reliable RAVI measurements with a mean of 25.1 mL/m2 (SD=15.5). In
patients who had sustained VFib/pVT, those with reduced LAVI (p=0.045)
and RAVI (p=0.041) values below the mean had significantly improved
survival time. No association was found in PEA/asystole. KM plots of
patient survival for both LAVI and RAVI compared to mean are presented
in figures 1a and 1b. Conclusion: Among patients presenting with a
Vifb/pVT arrest, increased LAVI and RAVI were associated with decreased
survival time.