Acute changes of global and longitudinal right ventricular function: an exploratory analysis in patients undergoing open-chest mitral valve surgery, percutaneous mitral valve repair and off-pump coronary artery bypass grafting.
Cardiovasc Ultrasound
; 18(1): 32, 2020 Aug 12.
Article
en En
| MEDLINE
| ID: mdl-32787878
ABSTRACT
BACKGROUND:
Right ventricular (RV) function is an important prognostic indicator. The acute effects of cardiac interventions or cardiac surgery on global and longitudinal RV function are not entirely understood. In this study, acute changes of RV function during mitral valve surgery (MVS), percutaneous mitral valve repair (PMVR) and off-pump coronary artery bypass surgery (OPCAB) were investigated employing 3D echocardiography.METHODS:
Twenty patients scheduled for MVS, 23 patients scheduled for PMVR and 25 patients scheduled for OPCAB were included retrospectively if patients had received 3D transesophageal echocardiography before and immediately after MVS, PMVR or OPCAB, respectively. RV global and longitudinal function was assessed using a 3D multiparameter set consisting of global right ventricular ejection fraction (RVEF), tricuspid annular plane systolic excursion (TAPSE), longitudinal contribution to RVEF (RVEFlong) and free wall longitudinal strain (FWLS).RESULTS:
Longitudinal RV function was significantly depressed immediately after MVS, as reflected by all parameters (RVEFlong 20 ± 5% vs. 13 ± 6%, p < 0.001, TAPSE 13.1 ± 5.1 mm vs. 11.0 ± 3.5 mm, p = 0.04 and FWLS -20.1 ± 7.1% vs. -15.4 ± 5.1%, p < 0.001, respectively). The global RVEF was slightly impaired, but the difference did not reach significance (37 ± 13% vs. 32 ± 9%, p = 0.15). In the PMVR group, both global and longitudinal RV function parameters were unaltered, whereas the OPCAB group showed a slight reduction of RVEFlong only (18 ± 7% vs. 14 ± 5%, p < 0.01). RVEFlong yielded moderate case-to-case but good overall reproducibility.CONCLUSIONS:
TAPSE, FWLS and RVEFlong reflect the depression of longitudinal compared to global RV function initially after MVS. PMVR alone had no impact, while OPCAB had a slight impact on longitudinal RV function. The prognostic implications of these phenomena remain unclear and require further investigation.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Disfunción Ventricular Derecha
/
Ecocardiografía Tridimensional
/
Puente de Arteria Coronaria Off-Pump
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Insuficiencia de la Válvula Mitral
Tipo de estudio:
Observational_studies
/
Prognostic_studies
Límite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Cardiovasc Ultrasound
Asunto de la revista:
ANGIOLOGIA
/
CARDIOLOGIA
/
DIAGNOSTICO POR IMAGEM
Año:
2020
Tipo del documento:
Article
País de afiliación:
Alemania