Evaluation of left and right ventricular myocardial function after lung resection using speckle tracking echocardiography

Abstract

The impact of major lung resections on myocardial function has not been well-investigated. We aimed to identify this impact through the use of speckle tracking echocardiography (STE) to evaluate the right and left ventricular myocardial function in patients who underwent lung resections.Thirty patients who had lung resections were recruited for this study. Ten patients who underwent pneumonectomies were matched by age and sex, with 20 patients who underwent lobectomies. STE was performed on both right and left ventricle (RV and LV). Strain values of pre and postlung resections were compared in both the pneumonectomy group and the lobectomy group. Comparison between the pneumonectomy group and the lobectomy group was also studied.Left ventricular ejection fraction remained normal (>55%), but significantly decreased after lung resection in both the pneumonectomy group and the lobectomy group. An accelerated heart rate was observed in both groups after lung resection, with the pneumonectomy group demonstrating extra rapid heart rate (P < 0.05). Strain values in the RV and LV decreased in both groups after lung resection, with the pneumonectomy group exhibiting a further decrease in longitudinal strain in LV and RV when compared with the lobectomy group (P < 0.05).Right and left ventricular dysfunction can occur after lung resection regardless of pneumonectomy or lobectomy, and lobectomy may have a less significant impact on myocardial functions. This study demonstrated that STE is able to detect acute cardiac dysfunction after lung resection.

The accuracy of electrical cardiometry for the noninvasive determination of cardiac output before and after lung surgeries compared to transthoracic echocardiography

“…These results were in agreement with Wang et al [ 15 ] who studied 30 patients underwent lung resections, and speckle tracking echocardiography was performed. EF significantly decreased after resection but stayed within the normal range >55% with significant increase in HR.…”

Echocardiographic Evaluation of Right Ventricular Function in the Immediate Postoperative Period after Major Pulmonary Resections: A Prospective Observational Study

“…16 There are reports evaluating the effects of lung resection on RV by using RV strain. 17 We demonstrated that in congruence with other parameters, RV strain deteriorated on POD 2 and later improved over one month. However, LV strain did not change significantly postoperatively.…”

Don't Forget the Right Ventricle

“…It has been demonstrated previously that more extensive lung resection is associated with postoperative RV dysfunction. 7,8 This has been hypothesized to result from larger increases in RV afterload associated with resection of larger proportions of the pulmonary vascular bed, negatively affecting RV function. It is plausible that the association between MINS and the extent of resection seen by Gonz alez-Tallada et al represents the potential for larger increases in RV afterload associated with pneumonectomy compared with smaller resections.…”