Department of Anesthesia, The Keenan Research Center at the Li Ka Shing Knowledge Institute, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
J Cardiothorac Vasc Anesth. 2010 Apr;24(2):275-9. doi: 10.1053/j.jvca.2009.10.022. Epub 2010 Jan 6.
Speckle tracking is an ultrasound method that assesses B-mode features to measure tissue displacement and derive deformation parameters. The objective of this study was to assess the feasibility of using speckle tracking in the measurement of right ventricular (RV) longitudinal strain during cardiac surgery using transesophageal echocardiography (TEE).
This was a prospective, observational cohort study.
A single university hospital setting.
Twenty-one patients without valvular disease referred for coronary artery bypass graft surgery were studied.
None.
After the induction of anesthesia and mechanical ventilation, transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) were used to obtain tricuspid annular plane systolic excursion (TAPSE), RV fractional area of change (FAC), and 2-dimensional strain analysis (speckle tracking) on 3 consecutive heart beats. There was a larger percentage of measurable segments achieved when using TEE. All segments could be analyzed per cardiac cycle in 73% of loops when using TEE and 38% when using TTE. The global strain value was similar using both methods (TEE: -20.4%, TTE: -20.1%). The TAPSE could be measured in only 52% of the segments using TTE and 100% using TEE. The FAC could be measured in 90.5% of the loops using TEE and in only 33.3% of the loops using TTE.
Perioperative measurements of RV strain using TEE in ventilated patients is feasible. The success rate was higher using TEE in ventilated patients under anesthesia. Differences between the 2 methods were likely the result of differences in 2-dimensional image quality.
斑点追踪是一种超声方法，它评估 B 模式特征以测量组织位移并得出变形参数。本研究的目的是评估在使用经食管超声心动图（TEE）的心脏手术期间使用斑点追踪测量右心室（RV）纵向应变的可行性。
这是一项前瞻性观察队列研究。
单家大学医院。
研究了 21 例无瓣膜病患者，他们因冠状动脉旁路移植术而接受检查。
无。
在麻醉和机械通气诱导后，使用经胸超声心动图（TTE）和经食管超声心动图（TEE）获得三尖瓣环平面收缩期位移（TAPSE）、RV 分数面积变化（FAC）和 2 维应变分析（斑点追踪），在 3 次连续心跳中。使用 TEE 可获得更多可测量的节段。在使用 TEE 时，73%的心动周期可以分析所有节段，而在使用 TTE 时则为 38%。两种方法的整体应变值相似（TEE：-20.4%，TTE：-20.1%）。TTE 仅能测量 52%的节段的 TAPSE，而 TEE 则能测量 100%的节段的 TAPSE。TEE 可测量 90.5%的环的 FAC，而 TTE 仅能测量 33.3%的环的 FAC。
在麻醉通气患者中使用 TEE 进行 RV 应变的围手术期测量是可行的。在麻醉通气患者中，使用 TEE 的成功率更高。两种方法之间的差异可能是由于二维图像质量的差异所致。
