BACKGROUND: Right ventricular (RV) function is a strong predictor of patient outcome after cardiac surgery. Limited studies have compared the predictive value of RV global longitudinal strain (RV-GLS) with tricuspid annular plane systolic excursion (TAPSE) and RV fractional area change (RVFAC) in this setting. METHODS: The study included 250 patients (66 ± 13 years old, LVEF = 52% ± 12%) referred for cardiac surgery (EuroSCORE-II = 4.8% ± 8.0%). RV function before surgery was assessed by RV-GLS by using speckle-tracking analysis (3-segment from the RV free wall), RVFAC and TAPSE was compared with postoperative outcome defined by 1-month mortality. RESULTS: Overall, 19 patients (7.6%) had RVFAC < 35%, 34 (13.6%) had TAPSE < 16 mm, and 99 (39.6%) had impaired RV-GLS > -21% (35% with normal RVFAC ≥ 35%). Postoperative death (n = 25) was higher in patients with abnormal RV-GLS > -21% (22% vs 3%; P < .0001), TAPSE < 16 mm (24% vs 8%; P = .007), and RVFAC < 35% (32% vs 9%; P = .001). Mortality was 3% in patients with preserved RV-GLS. In patients with preserved RVFAC ≥ 35% but abnormal RV-GLS, mortality was similar to that of those with RVFAC < 35% (20% vs 32%; P = .12). Among RV systolic indexes, only RV-GLS was associated with patient outcome by multivariate analysis adjusted to EuroSCORE-II and cardiopulmonary bypass duration. CONCLUSIONS: RV-GLS is a sensitive marker of RV dysfunction and correlates with postoperative mortality.
BACKGROUND: Right ventricular (RV) function is a strong predictor of patient outcome after cardiac surgery. Limited studies have compared the predictive value of RV global longitudinal strain (RV-GLS) with tricuspid annular plane systolic excursion (TAPSE) and RV fractional area change (RVFAC) in this setting. METHODS: The study included 250 patients (66 ± 13 years old, LVEF = 52% ± 12%) referred for cardiac surgery (EuroSCORE-II = 4.8% ± 8.0%). RV function before surgery was assessed by RV-GLS by using speckle-tracking analysis (3-segment from the RV free wall), RVFAC and TAPSE was compared with postoperative outcome defined by 1-month mortality. RESULTS: Overall, 19 patients (7.6%) had RVFAC < 35%, 34 (13.6%) had TAPSE < 16 mm, and 99 (39.6%) had impaired RV-GLS > -21% (35% with normal RVFAC ≥ 35%). Postoperative death (n = 25) was higher in patients with abnormal RV-GLS > -21% (22% vs 3%; P < .0001), TAPSE < 16 mm (24% vs 8%; P = .007), and RVFAC < 35% (32% vs 9%; P = .001). Mortality was 3% in patients with preserved RV-GLS. In patients with preserved RVFAC ≥ 35% but abnormal RV-GLS, mortality was similar to that of those with RVFAC < 35% (20% vs 32%; P = .12). Among RV systolic indexes, only RV-GLS was associated with patient outcome by multivariate analysis adjusted to EuroSCORE-II and cardiopulmonary bypass duration. CONCLUSIONS: RV-GLS is a sensitive marker of RV dysfunction and correlates with postoperative mortality.
Authors: Marius Keller; Tobias Lang; Andreas Schilling; Martina Nowak-Machen; Peter Rosenberger; Harry Magunia Journal: Int J Cardiovasc Imaging Date: 2019-07-18 Impact factor: 2.357
Authors: Shaun R Yockelson; Stephen B Heitner; Sarah Click; Gemechu Geleto; Miriam M Treggiari; Michael P Hutchens Journal: J Cardiothorac Vasc Anesth Date: 2018-09-12 Impact factor: 2.628
Authors: Diego Medvedofsky; Karima Addetia; Jamie Hamilton; Javier Leon Jimenez; Roberto M Lang; Victor Mor-Avi Journal: Int J Cardiovasc Imaging Date: 2015-05-07 Impact factor: 2.357
Authors: Felix Heggemann; Karsten Hamm; Joachim Brade; Florian Streitner; Christina Doesch; Theano Papavassiliu; Martin Borggrefe; Dariusch Haghi Journal: PLoS One Date: 2014-08-04 Impact factor: 3.240