The Limitations of Using Transthoracic Echocardiographic–Derived Normative Values for Grading Intraoperative Transesophageal Echocardiography Examinations of the Right Ventricle: Are They Really Interchangeable?

Gebhardt, B; Asher, Shyamal; Maslow, Andrew

doi:10.1053/j.jvca.2020.02.024

Cited by 2 publications

(3 citation statements)

References 22 publications

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“…The guidelines on RV function assessment focus on transthoracic echocardiography (TTE), while guidelines on transesophageal echocardiography (TEE) mainly neglect the evaluation of RV function [3,22]. Moreover, parameters assessed by TTE and TEE are not interchangeable, and normal values of RV function assessed by TEE are not well-established [23].…”

Section: Echocardiographymentioning

confidence: 99%

Role of Echocardiography for the Perioperative Assessment of the Right Ventricle

Labus

Uhlig

2021

Curr Anesthesiol Rep

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Purpose of Review This review aims to highlight the perioperative echocardiographic evaluation of right ventricular (RV) function with strengths and limitations of commonly used and evolving techniques. It explains the value of transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) and describes the perioperative changes of RV function echocardiographers should be aware of. Recent Findings RV dysfunction is an entity with strong influence on outcome. However, its definition and assessment in the perioperative interval are not well-defined. Moreover, values assessed by TTE and TEE are not interchangeable; while some parameters seem to correlate well, others do not. Myocardial strain analysis and three-dimensional echocardiography may overcome the limitations of conventional echocardiographic measures and provide further insight into perioperative cardiac mechanics. Summary Echocardiography has become an essential part of modern anesthesiology in patients with RV dysfunction. It offers the opportunity to evaluate not only global but also regional RV function and distinguish alterations of RV contraction.

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Section: Echocardiographymentioning

confidence: 99%

Role of Echocardiography for the Perioperative Assessment of the Right Ventricle

Labus

Uhlig

2021

Curr Anesthesiol Rep

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“…This evaluation is crucial for RV failure diagnosis, global hemodynamic management, and ventilator parameters setting (5). In daily practice, RV systolic parameters measured by TTE and by TTE are often used interchangeably and assumed clinically equivalent, even if their measurement must be done with caution (6). Actually, the values of conventional RV-systolic function parameters obtained in TTE and TEE were not comparable due to a large variability, a poor correlation (8), and an underestimation with TEE (7).…”

Section: Introductionmentioning

confidence: 99%

“…For some authors, RV strain parameters and 3D RV ejection fraction (3D-RVEF) should be used to avoid the variability and angle dependency of the conventional RV systolic parameters (6). However, the measurement of RV strain parameters and 3D-RVEF required high image quality and specific probes, thus limiting their use in clinical routine.…”

Section: Introductionmentioning

confidence: 99%

Interchangeability of right ventricular longitudinal shortening fraction assessed by transthoracic and transoesophageal echocardiography in the perioperative setting: A prospective study

Beyls

Huette²,

Vangreveninge³

et al. 2022

Front. Cardiovasc. Med.

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BackgroundConventional transthoracic (TTE) and transoesophageal echocardiography (TEE) parameters assessing right ventricle (RV) systolic function are daily used assuming their clinical interchangeability. RV longitudinal shortening fraction (RV-LSF) is a two-dimensional speckle tracking parameter used to assess RV systolic function. RV-LSF is based on tricuspid annular displacement analysis and could be measured with TTE or TEE.ObjectiveThe aim of the study was to determine if RV-LSFTTE and RV-LSFTEE measurements were interchangeable in the perioperative setting.MethodsProspective perioperative TTE and TEE echocardiography were performed under general anesthesia during scheduled cardiac surgery in 90 patients. RV-LSF was measured by semi-automatic software. Comparisons were performed using Pearson correlation and Bland-Altman plots. RV-LSF clinical agreement was determined as a range of −5 to 5%.ResultsOf the 114 patients who met the inclusion criteria, 90 were included. The mean preoperative RV-LSFTTE was 20.4 ± 4.3 and 21.1 ± 4.1% for RV-LSFTEE. The agreement between RV-LSF measurements was excellent, with a bias at −0.61 and limits of agreement of −4.18 to 2.97 %. All measurements fell within the determined clinical agreement interval in the Bland-Altman plot. Linear regression analysis showed a high correlation between RV-LSFTTE and RV-LSFTEE measurement (r = 0.9; confidence interval [CI] 95%: [0.87–0.94], p < 0.001).ConclusionRV-LSFTTE and RV-LSFTEE measurements are interchangeable, allowing RV-LSF to be a helpful parameter for assessing perioperative changes in RV systolic function.NCTNCT05404737. https://www.clinicaltrials.gov/ct2/show/NCT05404737.

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The Limitations of Using Transthoracic Echocardiographic–Derived Normative Values for Grading Intraoperative Transesophageal Echocardiography Examinations of the Right Ventricle: Are They Really Interchangeable?

Cited by 2 publications

References 22 publications

Role of Echocardiography for the Perioperative Assessment of the Right Ventricle

Role of Echocardiography for the Perioperative Assessment of the Right Ventricle

Interchangeability of right ventricular longitudinal shortening fraction assessed by transthoracic and transoesophageal echocardiography in the perioperative setting: A prospective study

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