Loading…
Echocardiographic predictors of intraoperative right ventricular dysfunction: a 2D and speckle tracking echocardiography study
Intraoperative or post procedure right ventricular (RV) dysfunction confers a poor prognosis in the post-operative period. Conventional predictors for RV function are limited due the effect of cardiac surgery on traditional RV indices; novel echocardiographic techniques hold the promise to improve R...
Saved in:
| Published in: | Cardiovascular ultrasound 2019-06, Vol.17 (1), p.11-11, Article 11 |
|---|---|
| Main Authors: | , , , , , , , , , |
| Format: | Article |
| Language: | English |
| Subjects: | |
| Citations: | Items that this one cites Items that cite this one |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| cited_by | cdi_FETCH-LOGICAL-c560t-af0c3cfcebac28b4fd759349c3733cbff5f314bc03fda454101800914a7d4cec3 |
|---|---|
| cites | cdi_FETCH-LOGICAL-c560t-af0c3cfcebac28b4fd759349c3733cbff5f314bc03fda454101800914a7d4cec3 |
| container_end_page | 11 |
| container_issue | 1 |
| container_start_page | 11 |
| container_title | Cardiovascular ultrasound |
| container_volume | 17 |
| creator | Rong, Lisa Q Yum, Brian Abouzeid, Christiane Palumbo, Maria Chiara Brouwer, Lillian R Devereux, Richard B Girardi, Leonard N Weinsaft, Jonathan W Gaudino, Mario Kim, Jiwon |
| description | Intraoperative or post procedure right ventricular (RV) dysfunction confers a poor prognosis in the post-operative period. Conventional predictors for RV function are limited due the effect of cardiac surgery on traditional RV indices; novel echocardiographic techniques hold the promise to improve RV functional stratification.
Comprehensive echocardiographic data were collected prospectively during elective cardiac surgery. Tricuspid annular plane systolic excursion (TAPSE), peak RV systolic velocity (S'), and RV fractional area change (FAC) were quantified on transesophageal echo (TEE). RV global and regional (septal and free wall) longitudinal strain was quantified using speckle-tracking echo in RV-focused views. Two intraoperative time points were used for comparison: pre-sternotomy (baseline) and after chest closure.
The population was comprised of 53 patients undergoing cardiac surgery [15.1% coronary artery bypass graft (CABG) only, 28.3% valve only, 50.9% combination (e.g. valve/CABG, valve/aortic graft) surgeries], among whom 38% had impaired RV function at baseline defined as RV FAC |
| doi_str_mv | 10.1186/s12947-019-0161-3 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_doaj_</sourceid><recordid>TN_cdi_doaj_primary_oai_doaj_org_article_3deed104ece54a579b2bcb8c3b5ff39e</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><doaj_id>oai_doaj_org_article_3deed104ece54a579b2bcb8c3b5ff39e</doaj_id><sourcerecordid>2340041131</sourcerecordid><originalsourceid>FETCH-LOGICAL-c560t-af0c3cfcebac28b4fd759349c3733cbff5f314bc03fda454101800914a7d4cec3</originalsourceid><addsrcrecordid>eNpdkk9v1DAQxSMEoqXwAbggS1y4BDyxnT8ckKpSoFIlLnC2nPF419tsHOxkpb3w2fGypepysGyN3_vZM3pF8Rr4e4C2_pCg6mRTcujyqqEUT4pzkE1dNlDxp4_OZ8WLlDacVxWI9nlxJgAaqURzXvy-xnVAE60Pq2imtUc2RbIe5xATC475cY4mTBTN7HfEol-tZ7ajXPW4DCYyu09uGXH2YfzIDKs-MzNalibCu4FYNuOdH1eMTt_ZszQvdv-yeObMkOjV_X5R_Pxy_ePqW3n7_evN1eVtiarmc2kcR4EOqTdYtb10tlGdkB2KRgjsnVNOgOyRC2eNVBI4tJx3IE1jJRKKi-LmyLXBbPQU_dbEvQ7G67-FEFfaxNnjQFpYIgtcEpKSRjVdX_XYtyh65ZzoKLM-HVnT0m_J4mEWZjiBnt6Mfq1XYadrlZuBNgPe3QNi-LVQmvXWJ6RhMCOFJelKSM4lgIAsffufdBOWOOZR6aqSopaq4Sqr4KjCGFKK5B4-A1wfkqKPSdE5KfqQFC2y583jLh4c_6Ih_gDQrr4Z</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2243645705</pqid></control><display><type>article</type><title>Echocardiographic predictors of intraoperative right ventricular dysfunction: a 2D and speckle tracking echocardiography study</title><source>PubMed Central</source><source>ProQuest Publicly Available Content database</source><creator>Rong, Lisa Q ; Yum, Brian ; Abouzeid, Christiane ; Palumbo, Maria Chiara ; Brouwer, Lillian R ; Devereux, Richard B ; Girardi, Leonard N ; Weinsaft, Jonathan W ; Gaudino, Mario ; Kim, Jiwon</creator><creatorcontrib>Rong, Lisa Q ; Yum, Brian ; Abouzeid, Christiane ; Palumbo, Maria Chiara ; Brouwer, Lillian R ; Devereux, Richard B ; Girardi, Leonard N ; Weinsaft, Jonathan W ; Gaudino, Mario ; Kim, Jiwon</creatorcontrib><description>Intraoperative or post procedure right ventricular (RV) dysfunction confers a poor prognosis in the post-operative period. Conventional predictors for RV function are limited due the effect of cardiac surgery on traditional RV indices; novel echocardiographic techniques hold the promise to improve RV functional stratification.
Comprehensive echocardiographic data were collected prospectively during elective cardiac surgery. Tricuspid annular plane systolic excursion (TAPSE), peak RV systolic velocity (S'), and RV fractional area change (FAC) were quantified on transesophageal echo (TEE). RV global and regional (septal and free wall) longitudinal strain was quantified using speckle-tracking echo in RV-focused views. Two intraoperative time points were used for comparison: pre-sternotomy (baseline) and after chest closure.
The population was comprised of 53 patients undergoing cardiac surgery [15.1% coronary artery bypass graft (CABG) only, 28.3% valve only, 50.9% combination (e.g. valve/CABG, valve/aortic graft) surgeries], among whom 38% had impaired RV function at baseline defined as RV FAC < 35%. All conventional RV functional indices including TAPSE, S' and FAC declined immediately following CPB (1.5 ± 0.3 vs.1.1 ± 0.3 cm, 8.0 ± 2.1 vs. 6.2 ± 2.5 cm/s, 36.8 ± 9.3 vs. 29.3 ± 10.6%; p < 0.001 for all). However, left ventricular (LV) and RV hemodynamic parameters remained unchanged (LV ejection fraction (EF): 56.8 ± 13.0 vs. 55.8 ± 12.9%; p = 0.40, pulmonary artery systolic pressure (PASP): 26.5 ± 7.4 vs 27.3 ± 6.7 mmHg; p = 0.13). Speckle tracking echocardiographic data demonstrated a significant decline in RV global longitudinal strain (GLS) [19.0 ± 6.5 vs. 13.5 ± 6.9%, p < 0.001]. Pre-procedure FAC, GLS and free wall strain predicted RV dysfunction at chest closure (34.7 ± 9.1 vs. 41.6 ± 8.1%, p = 0.01, 17.7 ± 6.5 vs. 21.8 ± 5.4%; p = 0.03, 20.3 ± 6.4 vs. 24.2 ± 5.8%; p = 0.04), whereas traditional linear RV indices such as TAPSE and RV S' at baseline had no impact on intraoperative RV dysfunction (p = NS for both).
Global and regional RV function, as measured by 2D indices and strain, acutely decline intraoperatively. Impaired RV strain is associated with intraoperative RV functional decline and provides incremental value to traditional RV indices in predicting those who will develop RV dysfunction.</description><identifier>ISSN: 1476-7120</identifier><identifier>EISSN: 1476-7120</identifier><identifier>DOI: 10.1186/s12947-019-0161-3</identifier><identifier>PMID: 31174537</identifier><language>eng</language><publisher>England: BioMed Central</publisher><subject>2D speckle tracking ; Aged ; Aorta ; Blood pressure ; Bypass ; Cardiac surgery ; Cardiac Surgical Procedures ; Cardiovascular disease ; Chest ; Coronary artery ; Coronary vessels ; Echocardiography ; Echocardiography, Three-Dimensional - methods ; Echocardiography, Transesophageal - methods ; Elective Surgical Procedures ; Esophagus ; Female ; Heart ; Heart failure ; Heart surgery ; Heart Ventricles - diagnostic imaging ; Heart Ventricles - physiopathology ; Hemodynamics ; Humans ; Hypertension ; Intraoperative Period ; Intraoperative transesophageal echocardiography ; Male ; Middle Aged ; Mortality ; Population ; Postoperative Complications ; Predictive Value of Tests ; Prospective Studies ; Pulmonary artery ; Right ventricular function ; Stroke Volume - physiology ; Surgery ; Systole ; Systolic pressure ; Tracking ; Ventricle ; Ventricular Dysfunction, Right - diagnosis ; Ventricular Dysfunction, Right - etiology ; Ventricular Dysfunction, Right - physiopathology ; Ventricular Function, Right - physiology</subject><ispartof>Cardiovascular ultrasound, 2019-06, Vol.17 (1), p.11-11, Article 11</ispartof><rights>2019. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s). 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c560t-af0c3cfcebac28b4fd759349c3733cbff5f314bc03fda454101800914a7d4cec3</citedby><cites>FETCH-LOGICAL-c560t-af0c3cfcebac28b4fd759349c3733cbff5f314bc03fda454101800914a7d4cec3</cites><orcidid>0000-0002-8420-8604</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6556018/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2243645705?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,25732,27903,27904,36991,36992,44569,53770,53772</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31174537$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rong, Lisa Q</creatorcontrib><creatorcontrib>Yum, Brian</creatorcontrib><creatorcontrib>Abouzeid, Christiane</creatorcontrib><creatorcontrib>Palumbo, Maria Chiara</creatorcontrib><creatorcontrib>Brouwer, Lillian R</creatorcontrib><creatorcontrib>Devereux, Richard B</creatorcontrib><creatorcontrib>Girardi, Leonard N</creatorcontrib><creatorcontrib>Weinsaft, Jonathan W</creatorcontrib><creatorcontrib>Gaudino, Mario</creatorcontrib><creatorcontrib>Kim, Jiwon</creatorcontrib><title>Echocardiographic predictors of intraoperative right ventricular dysfunction: a 2D and speckle tracking echocardiography study</title><title>Cardiovascular ultrasound</title><addtitle>Cardiovasc Ultrasound</addtitle><description>Intraoperative or post procedure right ventricular (RV) dysfunction confers a poor prognosis in the post-operative period. Conventional predictors for RV function are limited due the effect of cardiac surgery on traditional RV indices; novel echocardiographic techniques hold the promise to improve RV functional stratification.
Comprehensive echocardiographic data were collected prospectively during elective cardiac surgery. Tricuspid annular plane systolic excursion (TAPSE), peak RV systolic velocity (S'), and RV fractional area change (FAC) were quantified on transesophageal echo (TEE). RV global and regional (septal and free wall) longitudinal strain was quantified using speckle-tracking echo in RV-focused views. Two intraoperative time points were used for comparison: pre-sternotomy (baseline) and after chest closure.
The population was comprised of 53 patients undergoing cardiac surgery [15.1% coronary artery bypass graft (CABG) only, 28.3% valve only, 50.9% combination (e.g. valve/CABG, valve/aortic graft) surgeries], among whom 38% had impaired RV function at baseline defined as RV FAC < 35%. All conventional RV functional indices including TAPSE, S' and FAC declined immediately following CPB (1.5 ± 0.3 vs.1.1 ± 0.3 cm, 8.0 ± 2.1 vs. 6.2 ± 2.5 cm/s, 36.8 ± 9.3 vs. 29.3 ± 10.6%; p < 0.001 for all). However, left ventricular (LV) and RV hemodynamic parameters remained unchanged (LV ejection fraction (EF): 56.8 ± 13.0 vs. 55.8 ± 12.9%; p = 0.40, pulmonary artery systolic pressure (PASP): 26.5 ± 7.4 vs 27.3 ± 6.7 mmHg; p = 0.13). Speckle tracking echocardiographic data demonstrated a significant decline in RV global longitudinal strain (GLS) [19.0 ± 6.5 vs. 13.5 ± 6.9%, p < 0.001]. Pre-procedure FAC, GLS and free wall strain predicted RV dysfunction at chest closure (34.7 ± 9.1 vs. 41.6 ± 8.1%, p = 0.01, 17.7 ± 6.5 vs. 21.8 ± 5.4%; p = 0.03, 20.3 ± 6.4 vs. 24.2 ± 5.8%; p = 0.04), whereas traditional linear RV indices such as TAPSE and RV S' at baseline had no impact on intraoperative RV dysfunction (p = NS for both).
Global and regional RV function, as measured by 2D indices and strain, acutely decline intraoperatively. Impaired RV strain is associated with intraoperative RV functional decline and provides incremental value to traditional RV indices in predicting those who will develop RV dysfunction.</description><subject>2D speckle tracking</subject><subject>Aged</subject><subject>Aorta</subject><subject>Blood pressure</subject><subject>Bypass</subject><subject>Cardiac surgery</subject><subject>Cardiac Surgical Procedures</subject><subject>Cardiovascular disease</subject><subject>Chest</subject><subject>Coronary artery</subject><subject>Coronary vessels</subject><subject>Echocardiography</subject><subject>Echocardiography, Three-Dimensional - methods</subject><subject>Echocardiography, Transesophageal - methods</subject><subject>Elective Surgical Procedures</subject><subject>Esophagus</subject><subject>Female</subject><subject>Heart</subject><subject>Heart failure</subject><subject>Heart surgery</subject><subject>Heart Ventricles - diagnostic imaging</subject><subject>Heart Ventricles - physiopathology</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Intraoperative Period</subject><subject>Intraoperative transesophageal echocardiography</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Population</subject><subject>Postoperative Complications</subject><subject>Predictive Value of Tests</subject><subject>Prospective Studies</subject><subject>Pulmonary artery</subject><subject>Right ventricular function</subject><subject>Stroke Volume - physiology</subject><subject>Surgery</subject><subject>Systole</subject><subject>Systolic pressure</subject><subject>Tracking</subject><subject>Ventricle</subject><subject>Ventricular Dysfunction, Right - diagnosis</subject><subject>Ventricular Dysfunction, Right - etiology</subject><subject>Ventricular Dysfunction, Right - physiopathology</subject><subject>Ventricular Function, Right - physiology</subject><issn>1476-7120</issn><issn>1476-7120</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNpdkk9v1DAQxSMEoqXwAbggS1y4BDyxnT8ckKpSoFIlLnC2nPF419tsHOxkpb3w2fGypepysGyN3_vZM3pF8Rr4e4C2_pCg6mRTcujyqqEUT4pzkE1dNlDxp4_OZ8WLlDacVxWI9nlxJgAaqURzXvy-xnVAE60Pq2imtUc2RbIe5xATC475cY4mTBTN7HfEol-tZ7ajXPW4DCYyu09uGXH2YfzIDKs-MzNalibCu4FYNuOdH1eMTt_ZszQvdv-yeObMkOjV_X5R_Pxy_ePqW3n7_evN1eVtiarmc2kcR4EOqTdYtb10tlGdkB2KRgjsnVNOgOyRC2eNVBI4tJx3IE1jJRKKi-LmyLXBbPQU_dbEvQ7G67-FEFfaxNnjQFpYIgtcEpKSRjVdX_XYtyh65ZzoKLM-HVnT0m_J4mEWZjiBnt6Mfq1XYadrlZuBNgPe3QNi-LVQmvXWJ6RhMCOFJelKSM4lgIAsffufdBOWOOZR6aqSopaq4Sqr4KjCGFKK5B4-A1wfkqKPSdE5KfqQFC2y583jLh4c_6Ih_gDQrr4Z</recordid><startdate>20190607</startdate><enddate>20190607</enddate><creator>Rong, Lisa Q</creator><creator>Yum, Brian</creator><creator>Abouzeid, Christiane</creator><creator>Palumbo, Maria Chiara</creator><creator>Brouwer, Lillian R</creator><creator>Devereux, Richard B</creator><creator>Girardi, Leonard N</creator><creator>Weinsaft, Jonathan W</creator><creator>Gaudino, Mario</creator><creator>Kim, Jiwon</creator><general>BioMed Central</general><general>BMC</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>M7Z</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-8420-8604</orcidid></search><sort><creationdate>20190607</creationdate><title>Echocardiographic predictors of intraoperative right ventricular dysfunction: a 2D and speckle tracking echocardiography study</title><author>Rong, Lisa Q ; Yum, Brian ; Abouzeid, Christiane ; Palumbo, Maria Chiara ; Brouwer, Lillian R ; Devereux, Richard B ; Girardi, Leonard N ; Weinsaft, Jonathan W ; Gaudino, Mario ; Kim, Jiwon</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c560t-af0c3cfcebac28b4fd759349c3733cbff5f314bc03fda454101800914a7d4cec3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>2D speckle tracking</topic><topic>Aged</topic><topic>Aorta</topic><topic>Blood pressure</topic><topic>Bypass</topic><topic>Cardiac surgery</topic><topic>Cardiac Surgical Procedures</topic><topic>Cardiovascular disease</topic><topic>Chest</topic><topic>Coronary artery</topic><topic>Coronary vessels</topic><topic>Echocardiography</topic><topic>Echocardiography, Three-Dimensional - methods</topic><topic>Echocardiography, Transesophageal - methods</topic><topic>Elective Surgical Procedures</topic><topic>Esophagus</topic><topic>Female</topic><topic>Heart</topic><topic>Heart failure</topic><topic>Heart surgery</topic><topic>Heart Ventricles - diagnostic imaging</topic><topic>Heart Ventricles - physiopathology</topic><topic>Hemodynamics</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Intraoperative Period</topic><topic>Intraoperative transesophageal echocardiography</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Population</topic><topic>Postoperative Complications</topic><topic>Predictive Value of Tests</topic><topic>Prospective Studies</topic><topic>Pulmonary artery</topic><topic>Right ventricular function</topic><topic>Stroke Volume - physiology</topic><topic>Surgery</topic><topic>Systole</topic><topic>Systolic pressure</topic><topic>Tracking</topic><topic>Ventricle</topic><topic>Ventricular Dysfunction, Right - diagnosis</topic><topic>Ventricular Dysfunction, Right - etiology</topic><topic>Ventricular Dysfunction, Right - physiopathology</topic><topic>Ventricular Function, Right - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rong, Lisa Q</creatorcontrib><creatorcontrib>Yum, Brian</creatorcontrib><creatorcontrib>Abouzeid, Christiane</creatorcontrib><creatorcontrib>Palumbo, Maria Chiara</creatorcontrib><creatorcontrib>Brouwer, Lillian R</creatorcontrib><creatorcontrib>Devereux, Richard B</creatorcontrib><creatorcontrib>Girardi, Leonard N</creatorcontrib><creatorcontrib>Weinsaft, Jonathan W</creatorcontrib><creatorcontrib>Gaudino, Mario</creatorcontrib><creatorcontrib>Kim, Jiwon</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health Medical collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>Advanced Technologies & Aerospace Database (1962 - current)</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Biological Science Journals</collection><collection>Biochemistry Abstracts 1</collection><collection>ProQuest advanced technologies & aerospace journals</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest Publicly Available Content database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Cardiovascular ultrasound</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rong, Lisa Q</au><au>Yum, Brian</au><au>Abouzeid, Christiane</au><au>Palumbo, Maria Chiara</au><au>Brouwer, Lillian R</au><au>Devereux, Richard B</au><au>Girardi, Leonard N</au><au>Weinsaft, Jonathan W</au><au>Gaudino, Mario</au><au>Kim, Jiwon</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Echocardiographic predictors of intraoperative right ventricular dysfunction: a 2D and speckle tracking echocardiography study</atitle><jtitle>Cardiovascular ultrasound</jtitle><addtitle>Cardiovasc Ultrasound</addtitle><date>2019-06-07</date><risdate>2019</risdate><volume>17</volume><issue>1</issue><spage>11</spage><epage>11</epage><pages>11-11</pages><artnum>11</artnum><issn>1476-7120</issn><eissn>1476-7120</eissn><abstract>Intraoperative or post procedure right ventricular (RV) dysfunction confers a poor prognosis in the post-operative period. Conventional predictors for RV function are limited due the effect of cardiac surgery on traditional RV indices; novel echocardiographic techniques hold the promise to improve RV functional stratification.
Comprehensive echocardiographic data were collected prospectively during elective cardiac surgery. Tricuspid annular plane systolic excursion (TAPSE), peak RV systolic velocity (S'), and RV fractional area change (FAC) were quantified on transesophageal echo (TEE). RV global and regional (septal and free wall) longitudinal strain was quantified using speckle-tracking echo in RV-focused views. Two intraoperative time points were used for comparison: pre-sternotomy (baseline) and after chest closure.
The population was comprised of 53 patients undergoing cardiac surgery [15.1% coronary artery bypass graft (CABG) only, 28.3% valve only, 50.9% combination (e.g. valve/CABG, valve/aortic graft) surgeries], among whom 38% had impaired RV function at baseline defined as RV FAC < 35%. All conventional RV functional indices including TAPSE, S' and FAC declined immediately following CPB (1.5 ± 0.3 vs.1.1 ± 0.3 cm, 8.0 ± 2.1 vs. 6.2 ± 2.5 cm/s, 36.8 ± 9.3 vs. 29.3 ± 10.6%; p < 0.001 for all). However, left ventricular (LV) and RV hemodynamic parameters remained unchanged (LV ejection fraction (EF): 56.8 ± 13.0 vs. 55.8 ± 12.9%; p = 0.40, pulmonary artery systolic pressure (PASP): 26.5 ± 7.4 vs 27.3 ± 6.7 mmHg; p = 0.13). Speckle tracking echocardiographic data demonstrated a significant decline in RV global longitudinal strain (GLS) [19.0 ± 6.5 vs. 13.5 ± 6.9%, p < 0.001]. Pre-procedure FAC, GLS and free wall strain predicted RV dysfunction at chest closure (34.7 ± 9.1 vs. 41.6 ± 8.1%, p = 0.01, 17.7 ± 6.5 vs. 21.8 ± 5.4%; p = 0.03, 20.3 ± 6.4 vs. 24.2 ± 5.8%; p = 0.04), whereas traditional linear RV indices such as TAPSE and RV S' at baseline had no impact on intraoperative RV dysfunction (p = NS for both).
Global and regional RV function, as measured by 2D indices and strain, acutely decline intraoperatively. Impaired RV strain is associated with intraoperative RV functional decline and provides incremental value to traditional RV indices in predicting those who will develop RV dysfunction.</abstract><cop>England</cop><pub>BioMed Central</pub><pmid>31174537</pmid><doi>10.1186/s12947-019-0161-3</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0002-8420-8604</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1476-7120 |
| ispartof | Cardiovascular ultrasound, 2019-06, Vol.17 (1), p.11-11, Article 11 |
| issn | 1476-7120 1476-7120 |
| language | eng |
| recordid | cdi_doaj_primary_oai_doaj_org_article_3deed104ece54a579b2bcb8c3b5ff39e |
| source | PubMed Central; ProQuest Publicly Available Content database |
| subjects | 2D speckle tracking Aged Aorta Blood pressure Bypass Cardiac surgery Cardiac Surgical Procedures Cardiovascular disease Chest Coronary artery Coronary vessels Echocardiography Echocardiography, Three-Dimensional - methods Echocardiography, Transesophageal - methods Elective Surgical Procedures Esophagus Female Heart Heart failure Heart surgery Heart Ventricles - diagnostic imaging Heart Ventricles - physiopathology Hemodynamics Humans Hypertension Intraoperative Period Intraoperative transesophageal echocardiography Male Middle Aged Mortality Population Postoperative Complications Predictive Value of Tests Prospective Studies Pulmonary artery Right ventricular function Stroke Volume - physiology Surgery Systole Systolic pressure Tracking Ventricle Ventricular Dysfunction, Right - diagnosis Ventricular Dysfunction, Right - etiology Ventricular Dysfunction, Right - physiopathology Ventricular Function, Right - physiology |
| title | Echocardiographic predictors of intraoperative right ventricular dysfunction: a 2D and speckle tracking echocardiography study |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-21T13%3A19%3A44IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_doaj_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Echocardiographic%20predictors%20of%20intraoperative%20right%20ventricular%20dysfunction:%20a%202D%20and%20speckle%20tracking%20echocardiography%20study&rft.jtitle=Cardiovascular%20ultrasound&rft.au=Rong,%20Lisa%20Q&rft.date=2019-06-07&rft.volume=17&rft.issue=1&rft.spage=11&rft.epage=11&rft.pages=11-11&rft.artnum=11&rft.issn=1476-7120&rft.eissn=1476-7120&rft_id=info:doi/10.1186/s12947-019-0161-3&rft_dat=%3Cproquest_doaj_%3E2340041131%3C/proquest_doaj_%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c560t-af0c3cfcebac28b4fd759349c3733cbff5f314bc03fda454101800914a7d4cec3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2243645705&rft_id=info:pmid/31174537&rfr_iscdi=true |