Induction of anesthesia does not alter tricuspid annular velocities: a tissue Doppler assessment

Tousignant, Claude; Bowry, Richard; Cruz, Juan Pablo; Mazer, C. David

doi:10.1007/s12630-009-9157-z

Cited by 5 publications

(3 citation statements)

References 29 publications

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“…Our data demonstrate that the longitudinal function of the right ventricle, as measured by indices that assess the movement of the lateral tricuspid annulus, namely, TAPSE and TDITVs’, are significantly reduced after anesthesia induction and IPPV. This confirms the previous findings of Tousignant et al that have shown a similar reduction in TAPSE [35]. But contrary to our results they did not experience a change in TDITVs’ what could be due to the different patient population, the smaller number of included patients or different ventilator settings.…”

Section: Discussionsupporting

confidence: 70%

The effects of anesthesia induction and positive pressure ventilation on right-ventricular function: an echocardiography-based prospective observational study

et al. 2019

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BackgroundGeneral anesthesia induction with the initiation of positive pressure ventilation creates a vulnerable phase for patients. The impact of positive intrathoracic pressure on cardiac performance has been studied but remains controversial. 3D echocardiography is a valid and MRI-validated bed-side tool to evaluate the right ventricle (RV). The aim of this study was to assess the impact of anesthesia induction (using midazolam, sufentanil and rocuronium, followed by sevoflurane) with positive pressure ventilation (PEEP 5, tidal volume 6–8 ml/kg) on 2D and 3D echocardiography derived parameters of RV function.MethodsA prospective observational study on fifty-three patients undergoing elective cardiac surgery in a tertiary care university hospital was designed. Transthoracic echocardiography exams were performed before and immediately after anesthesia induction and were recorded together with hemodynamic parameters and ventilator settings.ResultsAfter anesthesia induction TAPSE (mean difference − 1.6 mm (95% CI − 2.6 mm to − 0.7 mm; p = 0.0013) as well as the Tissue Doppler derived tricuspid annulus peak velocity (TDITVs’) were significantly reduced (mean difference − 1.9% (95% CI: − 2.6 to − 1.2; p < 0.0001), but global right ventricular ejection fraction (RVEF; p = 0.1607) and right ventricular stroke volume (RVSV; p = 0.1838) did not change.ConclusionsThis data shows a preserved right ventricular ejection fraction and right ventricular stroke volume after anesthesia induction and initiation of positive pressure ventilation. However, the baso-apical right ventricular function is significantly reduced. Larger studies are needed in order to determine the clinical impact of these findings especially in patients presenting with impaired right ventricular function before anesthesia induction.Trial registrationRetrospecitvely registered, 6th June 2016, ClinicalTrials.gov Identifier NCT02820727.

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Section: Discussionsupporting

confidence: 70%

The effects of anesthesia induction and positive pressure ventilation on right-ventricular function: an echocardiography-based prospective observational study

et al. 2019

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“…13 In a study examining elite endurance athletes, a higher RV IVA was found in the presence of reduced global longitudinal strain than that in the controls. 22 The reduced strain was thought to be the result of geometric changes in the RV in this athletic population as the RV wall and cavity sizes were increased when compared to those in the controls.…”

Section: Postoperative Iva Recoverymentioning

confidence: 97%

“…1,4,5 We previously demonstrated that induction of anesthesia does not alter TAPSE or S 0 . 13 It has also been suggested that reductions in markers of RV function begin during surgery, at the moment of pericardial opening. 14 The opening of the pericardial sac might induce changes in RV geometry, resulting in alterations in longitudinal parameters.…”

Section: \0001mentioning

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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The use of echocardiographic indices in defining and assessing right ventricular systolic function in critical care research

et al. 2018

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Induction of anesthesia does not alter tricuspid annular velocities: a tissue Doppler assessment

Cited by 5 publications

References 29 publications

The effects of anesthesia induction and positive pressure ventilation on right-ventricular function: an echocardiography-based prospective observational study

The effects of anesthesia induction and positive pressure ventilation on right-ventricular function: an echocardiography-based prospective observational study

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

The use of echocardiographic indices in defining and assessing right ventricular systolic function in critical care research

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