Cardiovascular Adaptations and Complications

Pedoto, Alessia; Amar, David

doi:10.1007/978-1-4419-0184-2_44

Cited by 1 publication

(1 citation statement)

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“…Transthoracic echocardiographic (TTE) assessment of the RV, however, is challenging in this population; the difficulties of the RV's complex geometry, retrosternal position, and marked load dependence are compounded following thoracic surgery. [1819] Many of the conventional TTE parameters for assessing RV function are not valid in this population. [20] In comparison, the assessment of the left ventricular (LV) cavity is easier and more reliable; and therefore, a method of assessing RV function “indirectly” from the LV (as with eccentricity index [EI]) may have value in this setting.…”

Section: Introductionmentioning

confidence: 99%

The utility of eccentricity index as a measure of the right ventricular function in a lung resection cohort

Teng

McCall

Shelley

2019

J Cardiovasc Echography

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Context:Right ventricular (RV) dysfunction occurs after lung resection and is associated with postoperative morbidity. Noninvasive evaluation of the RV is challenging, particularly in the postoperative period. A reliable measure of RV function would have value in this population.Aims:This study compares eccentricity index (EI) obtained by transthoracic echocardiography (TTE) with cardiovascular magnetic resonance (CMR) determined measures of RV function in a lung resection cohort. CMR is the reference method for noninvasive assessment of RV function.Design and Setting:Prospective observational cohort study at a single tertiary hospital.Materials and Methods:Twenty-eight patients scheduled for elective lung resection underwent contemporaneous TTE and CMR imaging preoperatively, on postoperative day (POD) 2 and at 2-month. Systolic and diastolic EI was measured offline from anonymized and randomized TTE and CMR images.Statistical Analysis:Bland–Altman analysis was performed to determine agreement between EITTE and EICMR. Changes over time and comparison with CMR determined RV ejection fraction (RVEFCMR) was assessed.Results:Bland–Altman analysis showed a negligible mean difference between EITTE and EICMR, but limits of agreement were wide (SD 0.24 and 0.28). There were no significant changes in EITTE and EICMR over time (P > 0.35). We found no association between EITTE with RVEFCMR at all-time points (P > 0.22). Systolic and diastolic EICMR on POD 2 demonstrated moderate association with RVEFCMR (r = −0.54 and r = −0.59, P ≤ 0.01). At 2-month, only diastolic EICMR correlated with RVEFCMR (r = −0.43, P = 0.03). There were no meaningful associations between EITTE and EICMR with TTE-derived RV systolic pressure (P > 0.31).Conclusions:TTE determined EI is not useful as a noninvasive method of assessing RV function following lung resection.

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Section: Introductionmentioning

confidence: 99%