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Assessment of Acute Cardiac Function via Post-Resuscitation Triple-Rule-Out Computed Tomography

Andreas Kattner, Sufian S Ahmad, Alexander Benedikt Leichtle, Georg-Martin Fiedler, Aristomenis K Exadaktylos, Johannes Heverhagen and Dominik G Haider

Background: In patients with return of spontaneous circulation (ROSC) after resuscitation, the current gold standard for assessing acute cardiac function is cardiac echocardiography. However, its use may be limited in acute critically ill patients by delays, interobserver discrepancies or the varying priorities of radiographic examinations. We now report that standardised acute cardiac function in these patients can be assessed with triple rule out thoracic (TRO) computed tomography. Methods and patients: We retrospectively analysed cardiac function in all patients with ROSC after resuscitation and who underwent acute computed tomography between 01/2013 and 01/2015 with a new post processing software client after TRO- computed tomography angiography (n=15). The syngo-CT-cardiac-function-client (syngo.via VA 20, Siemens, Erlangen, Germany) was used to measure ejection fraction, myocardial mass, stroke volume, end systolic and end-diastolic volumes, as well as coronary morphology. Multivariate regression modelling and ROC analysis were used to control the independent associations between these parameters. Results: ROC curve analysis showed that right cardiac end systolic volume and left cardiac end systolic volume were associated with ROSC (AUC: 0.74 and AUC: 0.74, respectively). In these patients, we defined thresholds for right cardiac end systolic volume of 119 ml and for left cardiac end systolic volume of 48 ml. Conclusion: In combination with TRO computed tomography, the syngo-CT-cardiac-function-client provides a valuable, standardised tool to assess acute cardiac function in patients with ROSC after resuscitation.