Evaluation of Right Ventricular Systolic Function after Mitral Valve Repair: A Two-Dimensional Doppler, Speckle-Tracking, and Three-Dimensional Echocardiographic Study

Maffessanti, Francesco; Gripari, Paola; Tamborini, Gloria; Muratori, Manuela; Fusini, Laura; Alamanni, Francesco; Zanobini, Marco; Fiorentini, Cesare; Caiani, Enrico G.; Pepi, Mauro

doi:10.1016/j.echo.2012.03.017

Cited by 81 publications

(66 citation statements)

References 38 publications

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“…Speckle tracking-derived strain is a new modality for assessment of cardiac function (9). Maffessanti et al have indicated the usefulness of this modality in evaluation of RV function following mitral valve repair (10). However, there have been few studies evaluating RV performance with speckle tracking-derived strain following mitral valve repair.…”

Section: Introductionmentioning

confidence: 99%

Right Ventricular Performance After Valve Repair for Chronic Degenerative Mitral Regurgitation

Hyllén

Nozohoor

Ingvarsson

et al. 2014

The Annals of Thoracic Surgery

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Link to publication Citation for published version (APA): Hyllen, S., Nozohoor, S., Ingvarsson, A., Meurling, C., Wierup, P., & Sjögren, J. (2014). Right ventricular performance after valve repair for chronic degenerative mitral regurgitation. Annals of Thoracic Surgery, 98(6), 2023-2031. DOI: 10.1016/j.athoracsur.2014 General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.• Users may download and print one copy of any publication from the public portal for the purpose of private study or research.• You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal Right Ventricular Performance Following Valve Repair for Chronic Degenerative Mitral Regurgitation

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Section: Introductionmentioning

confidence: 99%

Right Ventricular Performance After Valve Repair for Chronic Degenerative Mitral Regurgitation

Hyllén

Nozohoor

Ingvarsson

et al. 2014

The Annals of Thoracic Surgery

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“…AT = acceleration time; IVA = isovolumic acceleration; S 0 = peak systolic velocity; TAPSE = tricuspid annular plane systolic excursion RV function have been shown to be depressed during the early postoperative period and up to several years after cardiac surgery. [1][2][3][4][9][10][11][12] One study suggested that these changes might be permanent. 4 Causes might include intraoperative ischemia, poor myocardial protection, and pericardial tethering or disruption.…”

Section: \0001mentioning

confidence: 99%

“…Studies have shown that measures of RV longitudinal function (base to apex displacement) are depressed after cardiac surgery, a condition that may persist for up to a month or more despite good functional recovery. [1][2][3][4][5] Finding a measure of longitudinal RV function that accurately reflects ventricular recovery would be helpful during the postoperative assessment.…”

Section: Résumémentioning

confidence: 99%

Early recovery of tricuspid annular isovolumic acceleration after mitral valve surgery – an observational study

Orman

Connelly

Albinmousa

et al. 2016

Can J Anesth/J Can Anesth

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Purpose Patients undergoing mitral valve surgery are at risk for right ventricular (RV) dysfunction resulting from increased left atrial pressure and increased pulmonary artery impedance. Measures of longitudinal measures of RV function, such as displacement, are commonly performed but have been shown to be depressed after cardiac surgery despite good patient recovery. The aim of this observational study was to assess the early perioperative time course of longitudinal transthoracic echocardiographic (TTE) markers of RV function in a patient population undergoing mitral valve surgery. Methods Twenty patients undergoing mitral valve surgery were enrolled in this observational study. Right ventricular longitudinal measurements (tricuspid annular plane systolic excursion [TAPSE], strain, annular velocity [S 0 ], and isovolumic acceleration [IVA]) were performed using TTE and colour Doppler imaging preoperatively (day 1) and postoperatively (days 2 and 6). Comparisons were made between the preoperative and postoperative measurements. Results Adequate echocardiographic imaging was obtained for all 20 patients. The TAPSE, strain, and S 0 measures remained depressed for up to one week (i.e., day 6) after surgery compared to preoperative values. The IVA was depressed on the first postoperative day (P [ 0.001), but by day 6 it was no different from the preoperative value (P = 0.37). The median [interquartile range] time to discharge from hospital was 7 [6-9] days. Conclusion Persistent, significant depression of longitudinal markers of RV function despite functional improvement (discharge from hospital) make it difficult to assess recovery during the early perioperative period. Isovolumic acceleration, a load-independent measure of contractility, might be a more reliable measure of early recovery in RV function in this patient population. RésuméObjectif Les patients subissant une chirurgie de valve mitrale courent le risque de dysfonction du ventricule droit (VD) résultant d'une augmentation de la pression auriculaire gauche et de l'impédance artérielle pulmonaire. Des mesures des mesures longitudinales de la fonction du VD, telles que le déplacement, sont fréquentes, mais il a été démontré qu'elles étaient diminuées après une chirurgie cardiaque malgré une bonne récupération du patient. L'objectif de cette étude observationnelle était d'évaluer le décours temporel périopératoire précoce des marqueurs longitudinaux de l'échocardiographie transthoracique (ETT) de la fonction VD dans une population de patients subissant une chirurgie de valve mitrale.This study was approved by the St Michael's hospital IRB.

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“…Real-time 3D techniques have been shown to accurately provide objective measurement of RV volumes 19 and are especially attractive after cardiac surgery, when conventional indices of longitudinal RV function are generally reduced. 20 Strain, particularly speckle tracking technique of the free wall, is a promising technique. Although less validated than in the LV, pooled data suggest that global longitudinal RV free wall strain lower than -20 % is likely abnormal.…”

Section: Right Ventricular Functionmentioning

confidence: 99%

Novel Imaging Techniques for Heart Failure

Melero-Ferrer

López‐Vilella

Morillas-Climent

et al. 2016

Cardiac Failure Review

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Heart failure (HF) is an epidemic with an increasing prevalence and an absolute mortality rate of approximately 50 % within 5 years of diagnosis. Imaging plays a main role in HF diagnosis, assessment of aetiology and treatment guidance. This article reviews current HF applications for all the available non-invasive imaging modalities: echocardiography, cardiovascular magnetic resonance (CMR), nuclear imaging-positron emission tomography (PET) and single-photon emission computed tomography (SPECT) and computed tomography (CT). Echocardiography, with its recent developments, such as 3D echo, is the main imaging test used in the evaluation of HF patients, given its availability and reliability in assessing cardiac structure and function. CMR allows the characterisation of myocardial tissue, in addition to providing information on the structure and cardiac function, so it is a great help in the determination of HF aetiology and may predict patient outcomes. Nuclear imaging can detect ischaemia and viability and can obtain additional prognostic data. Cardiac CT is EchocardiographyAlthough echocardiography is a relatively 'ancient' technique, its versatility makes it unique in the provision of volumes, function, haemodynamics or valvular regurgitation. In addition, because of its availability, safety and low cost, echocardiography is the first and most widely used test for the diagnosis, selection of appropriate treatment and prognosis of HF.1 Echocardiography is also the most used imaging method in the reassessment of HF patients. It remains unclear when to repeat echocardiographic exams, but it is deemed appropriate at least in patients with worsening symptoms. Systolic FunctionGlobal left ventricular (LV) function is of paramount importance regarding therapeutic decisions. Visual estimation of ejection fraction (EF), the Teichholz and Simpson methods, have been widely validated. 2,3However, in 2D imaging, because of its operator-dependent nature, repeated testing has a high probability of producing variable volume and EF results.The apparition of 3D fully sampled matrix transthoracic echocardiography has enabled easier acquisition of images, 4 simplifying its routinary application. There have been many studies comparing 2D and 3D echocardiography (2DE and 3DE) and a 'reference' standard (generally CMR). A recent meta-analysis of all 3DE studies evaluating LV volumes and EF demonstrated that 3DE generally underestimated volumes, but not as significantly as 2DE. There was also less variability than 2D compared with CMR.5 Nonetheless, 3DE echocardiography may be challenging and not practical in patients with low image quality (e.g. critical patients), in whom 2DE measures are more realiable. 3DE is also a less standardised techique than 2DE, and because of this reason most laboratories use the more universally applicable 2DE measurements in clinical practice. Only recently, large analyses of LV parameters using 3DE in large cohorts of healthy individuals have been published to establish race, age and gender-specific ...

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Evaluation of Right Ventricular Systolic Function after Mitral Valve Repair: A Two-Dimensional Doppler, Speckle-Tracking, and Three-Dimensional Echocardiographic Study

Cited by 81 publications

References 38 publications

Right Ventricular Performance After Valve Repair for Chronic Degenerative Mitral Regurgitation

Right Ventricular Performance After Valve Repair for Chronic Degenerative Mitral Regurgitation

Early recovery of tricuspid annular isovolumic acceleration after mitral valve surgery – an observational study

Novel Imaging Techniques for Heart Failure

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