Long-Term follow up of Myocardial Function in VA-ECMO

Abstract

Objective: There is limited evidence regarding the association between myocardial function and long-term survival rate in patients who reach hospital discharge. This study aimed to investigate the association between myocardial function parameters collected at different times from weaning to long-term follow-up and the long-term mortality rate. Method: A cohort of 403 patients successfully weaned from VA-ECMO was identified from a total of 1300 patients who underwent VA-ECMO between 2000-2018 after applying exclusion criteria for age and indications not of interest in the Chang Gung Memorial Hospital Research Database. A retrospective analysis was performed to investigate the effect of ejection fraction timing on long-term mortality. Results: Percentile improvement in EF between ECMO placement and successful weaning is significantly associated with lower cumulative mortality, while the EF value before discharge was significantly associated with better survival. Lastly, the association of lower long-term mortality with EF change from discharge to midterm follow-up and the maximum EF at midterm follow-up was found to be non-significant. Conclusions: This is the first study to provide a comprehensive analysis of echo-cardiographic parameters collected at different times and long-term cumulative mortality in patients who survived VA-ECMO. Improvements in cardiac function and better baseline cardiac function are associated with lower long-term mortality.