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

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. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This work was supported by a grant from Chang Gung Memorial Hospital, [Taiwan CORPG3M0371, CFRPG3M0011, CMRPG3L0101, CMRPG3L0102, CMRPG3L0103 and BMRPD95(SWC)]. This work was also supported by the Ministry of Science and Technology grant [Most 110-2314-B-182A-114 (SWC]. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Not Applicable The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Informed consent was obtained from the institutional review board of CGMH (approval number: 202100124B) I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Not Applicable I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Not Applicable I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Not Applicable all the data can be requested be email