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. 2025 Apr 14;12(1):9.
doi: 10.1186/s44156-025-00072-5.

Right atrium area is associated with survival after out-of-hospital cardiac arrest: a single-center cohort study

King Hei Dominic Cheng  1 , Samir Sulemane  1 , Sara Fontanella  1 , Petros Nihoyannopoulos  2
Affiliations

Right atrium area is associated with survival after out-of-hospital cardiac arrest: a single-center cohort study

King Hei Dominic Cheng et al. Echo Res Pract. .

Abstract

Background: Out-of-hospital cardiac arrest (OHCA) is associated with high mortality, highlighting the importance of identifying prognostic factors to guide treatment escalation plans. This study investigates the short-term prognostic potential of transthoracic echocardiogram (TTE), a commonly performed investigation in OHCA patients. This study is among the first to report left ventricle (LV) global longitudinal strain (LVGLS) in OHCA patients.

Methods: This single-center retrospective cohort study included 54 patients treated between 2019 and 2022, during the COVID-19 pandemic. Patient characteristics were reported using the 2015 Utstein template, and echocardiographic parameters were assessed following British Society of Echocardiography guidelines. Univariate analyses compared TTE parameters by survival-to-discharge and implantable cardioverter-defibrillator implantation outcomes. Correlations between LV ejection fraction (LVEF) derived from cardiac magnetic resonance imaging (cMRI) and echocardiographic LV systolic parameters were evaluated.

Results: The survival-to-discharge rate was 77.8%. Non-survivors had a significantly larger right atrium (RA) area (RAA) (20.8 cm2 vs. 15.2 cm2 in survivors; p = 0.003). No statistically significant differences were observed for other right or left heart parameters. The median LVGLS was reduced at -11.4% (interquartile range: -14.0 to -7.6). LVEF correlates well on cMRI and TTE (Pearson correlation coefficient = 0.830).

Conclusion: This study identifies a novel association between larger RAA and short-term mortality following OHCA, alongside a higher survival rate in a tertiary center. Further research should consider incorporating RA parameters into analyses to refine prognostic assessments.

Keywords: Cardioverter-defibrillator; Echocardiography; Global longitudinal strain; Out-of-hospital cardiac arrest; Right atrial area; Right atrium area; Survival.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was conducted as a part of the fulfillment of an MSc degree and ethics approval was waived by the Hammersmith Hospital Internal Review Board under local arrangements. Informed consent was not necessary as data collection constitutes the patients’ standard care. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

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References

    1. Berdowski J, Berg RA, Tijssen JGP, Koster RW. Global incidences of out-of-hospital cardiac arrest and survival rates: systematic review of 67 prospective studies. Resuscitation. 2010;81(11):1479–87. 10.1016/j.resuscitation.2010.08.006. - PubMed
    1. Geri G, Scales DC, Koh M, Wijeysundera HC, Lin S, Feldman M, Cheskes S, Dorian P, Isaranuwatchai W, Morrison LJ, Ko DT. Healthcare costs and resource utilization associated with treatment of out-of-hospital cardiac arrest. Resuscitation. 2020;153:234–42. 10.1016/j.resuscitation.2020.04.032. - PubMed
    1. Søholm H, Laursen ML, Kjaergaard J, Lindhardt TB, Hassager C, Møller JE, Gregers E, Linde L, Johansen JB, Winther-Jensen J, Lippert FK, Køber L, Philber BT. Early ICD implantation in cardiac arrest survivors with acute coronary syndrome– predictors of implantation, ICD-therapy and long-term survival. Scandinavian Cardiovasc J. 2021;55(4):205–12. 10.1080/14017431.2021.1900597. - PubMed
    1. Myat A, Song K-J, Rea T. Out-of-hospital cardiac arrest: current concepts. Lancet. 2018;391(10124):970–9. 10.1016/s0140-6736(18)30472-0. - PubMed
    1. National Institute for Health and Care Excellence (NICE). (2014) Implantable cardioverter defibrillators and cardiac resynchronisation therapy for arrhythmias and heart failure. (TA314). National Institute for Health and Care Excellence. https://www.nice.org.uk/guidance/ta314/resources/implantable-cardioverte... [Accessed 22nd July 2022].

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