{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T08:37:28Z","timestamp":1777711048505,"version":"3.51.4"},"reference-count":36,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,3,23]],"date-time":"2023-03-23T00:00:00Z","timestamp":1679529600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Left ventricular (LV) dysfunction is estimated to occur in 10%\u201325% of the general intensive care unit (ICU) population and is frequently seen as regional wall motion abnormalities (RWMAs). Although RWMA is mostly attributed to myocardial ischemia or infarction, some studies have suggested that nonischemic RWMA might also be prevalent. We sought to establish that RWMA can be seen in critically ill patients with normal coronary arteries and to explore reasons for RWMA in this population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this retrospective study, data from the hospital angiography register and the ICU register were collated between 2012 and 2019. Patients were identified who underwent angiography in conjunction with their ICU stay and had RWMA on echocardiography. Patients were divided into either those with non\u2010obstructed or those with obstructed coronary arteries. Cardiac magnetic resonance imaging (cMRI) examinations were reviewed if they had been performed on patients with non\u2010obstructed coronaries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 53 patients with RWMA and non\u2010obstructed coronary arteries and 204 patients with RWMA and obstructed coronary arteries. Patients with non\u2010obstructed coronary arteries were more often female, younger, and had fewer cardiovascular risk factors. They less commonly had ST elevation, but more frequently had T\u2010wave inversion or serious arrhythmias. Troponin levels were higher in patients with obstructed coronary arteries, but NT\u2010proBNP was similar between the groups. There were no differences in risk\u2010adjusted 90\u2010day mortality between patients with non\u2010obstructed versus obstructed coronary arteries (OR 1.21, [95% CI 0.56\u20132.64], <jats:italic>p<\/jats:italic>\u00a0=\u2009.628). In those with non\u2010obstructed coronary arteries, follow\u2010up echocardiography was available for 38 patients, of whom 30 showed normalization of cardiac function. Of the 14 patients with non\u2010obstructed coronary arteries on whom cMRI was performed, 7 had a tentative diagnosis of Takotsubo syndrome or myocardial stunning; 4 had a myocardial infarction (preexisting in 3 cases); 1 patient had acute myocarditis; 1 patient had post\u2010myocarditis; and 1 patient was diagnosed with dilated cardiomyopathy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>RWMA can be seen to occur in critically ill patients in the absence of coronary artery obstruction. Several conditions can cause regional hypokinesia, and cMRI is useful to evaluate the underlying etiology.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.14234","type":"journal-article","created":{"date-parts":[[2023,3,14]],"date-time":"2023-03-14T06:34:50Z","timestamp":1678775690000},"page":"746-754","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["RWMAs in critically ill patients with non\u2010obstructed coronary arteries"],"prefix":"10.1111","volume":"67","author":[{"given":"Elin","family":"Rosen\u2010Wetterholm","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, Sahlgrenska Academy University of Gothenburg  Gothenburg Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oscar","family":"Cavefors","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, Sahlgrenska Academy University of Gothenburg  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