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Medicina crítica (Colegio Mexicano de Medicina Crítica)

versão impressa ISSN 2448-8909

Resumo

GARCIA SANCHEZ, Manuel I et al. Diagnostic accuracy of the integral time-velocity of the outflow tract for cardiogenic shock: prospective cohort. Med. crít. (Col. Mex. Med. Crít.) [online]. 2023, vol.37, n.2, pp.95-98.  Epub 13-Maio-2024. ISSN 2448-8909.  https://doi.org/10.35366/110443.

Introduction:

cardiogenic shock (CC) is a state of systemic hypoperfusion caused by severe cardiac dysfunction. The measurement of the integral time-velocity of the left ventricular outflow tract (ITV-LVOT) < 15 cm allows to evaluate the presence of shock.

Objective:

to evaluate the ITV-TSVI < 15 cm as a predictor of cardiogenic shock in the patient with ST-segment elevation anterior acute myocardial infarction (ST-AMI).

Material and methods:

prospective observational study conducted from May to October 2019. Patients with previous ST-AMI and revascularization by percutaneous coronary intervention were included. TVI-LVOT was measured by transthoracic echocardiography, the demographic and clinical variables of patients with TVI-LVOT < 15 cm vs. those with TVI-LVOT ≥ 15 cm were recorded and compared, and the diagnostic accuracy of TVI-LVOT < 15 cm to predict cardiogenic shock was calculated.

Results:

data from 50 patients were analyzed with a mean age of 63.5 ± 9.9 years, 70% were men, 54% had cardiogenic shock, and TVI-LVOT < 15 cm occurred in 95.8% of those patients with shock. cardiogenic. The diagnostic accuracy of the TVI-LVOT < 15 cm for cardiogenic shock in patients with anterior ST-AMI showed sensitivity of 85% and specificity of 96%, with area under the curve: 0.90 (95% CI: 0.81-0.99).

Conclusion:

The TVI-LVOT < 15 cm in patients with anterior ST-AMI has a very good diagnostic accuracy for the prediction of cardiogenic shock.

Palavras-chave : doppler pulsed echocardiography; anterior wall myocardial infarction; cardiogenic shock.

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