Evaluation of the effect of coronary artery bypass grafting on the right ventricular function using speckle tracking echocardiography

Abstract

Purpose: This was a prospective study conducted at Benha University hospital and National Heart Institute on one hundred patients undwent coronary artery bypass grafting (CABG) to evaluate the effect of CABG on the right ventricular (RV) function using speckle tracking echocardiography (STE). Methods: All cases were subjected to detailed medical history, full physical examination, 12 leads electrocardiogram (ECG), routine laboratory tests including (complete blood picture, liver functions, renal functions and lipid profi le) and echocardiography either conventional echocardiography or STE, all parameters obtained before and within 2 weeks after surgery. Results: By conventional echocardiography there was statistically signifi cant decrease in peak right ventricle systolic velociy (RVS´) from (12.76 ± 1.72) to (7.33 ± 1.71) and tricuspid annular plane systolic excursion (TAPSE) from (22.8 ± 3.99) to (13.77 ± 4.63) among the studied patients after CABG. While there was signifi cant increase in right ventricle fractional area change (RVFAC) from (44.69 ± 3.25) to (49.01 ± 3.36). On the other hand, there was non-signifi cant change in right ventricle end diastolic diameter (RVEDD) at mid-cavity from (26.37 ± 2.72) to (26.53 ± 2.72) and basal segment from (36.05 ± 2.98) to (36.29 ± 3.04), right ventricle stroke volume (RVSV) from (65.44 ± 7.02) to (65.85 ± 6.86) and right myocardial performance index (RMPI) from (0.491 ± 0.088) to (0.498 ± 0.086). Statistical analysis Data analysis was performed using the software SPSS (Statistical Package for the Social Sciences) version 20.

Paradoxical Septal Motion after Uncomplicated Cardiac Surgery: A Consequence of Altered Regional Right Ventricular Contractile Patterns

“…Recently, others have investigated the observation of normal global RV output and altered regional RV contractile patterns after CS with advanced speckle tracking by directly measuring RV longitudinal and transverse displacement and peak systolic strain, a measure of myocardial fiber contractile movement [ 32 , 45 , 46 , 51 - 53 ]. Strain is a measure of myocardial deformation, a change in the length of a segment relative to its baseline length.…”

“…Some studies have shown no reduction in septal strain in CABG patients [ 46 , 53 , 55 ]. Others have reported a decrease in septal strain [ 51 , 52 ]. Donauer studied RV and septal strain in 30 patients undergoing CABG [ 52 ].…”