Gao Zhifeng, Bortman Jeffrey, Mahmood Faraz, Mitchell John, Mahmood Feroze, Matyal Robina
Department of Anesthesiology, Peking University International Hospital, Beijing, China; Departments of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
Departments of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
J Cardiothorac Vasc Anesth. 2018 Aug;32(4):1759-1767. doi: 10.1053/j.jvca.2018.02.014. Epub 2018 Feb 9.
To test the feasibility and reliability of using a vendor-neutral platform to evaluate right ventricular (RV) strain. Reliability was determined by comparing intra- and inter-observer variability between RV strain assessments. The secondary objective was to assess strain's correlation with conventional RV functional parameters to evaluate its feasibility as a RV systolic functional assessment tool.
This is a retrospective study.
Tertiary hospital.
A total of 15 patients who underwent elective coronary artery bypass graft surgery were selected for inclusion.
None.
Images obtained during routine, intraoperative, two-dimensional transesophageal echocardiography (2D TEE) were assessed for longitudinal strain (LS) and conventional parameters, including fractional area change (FAC), tricuspid annular plane systolic excursion (TAPSE), Doppler tissue imaging (DTI)-derived tricuspid lateral annular systolic velocity wave (S'), and RV dimensions using vendor-neutral software. There was good to excellent intra- and inter-observer reproducibility (intraclass correlation coefficient [ICC] from 0.75 to 1.00) with the exception of basal free wall longitudinal strain (FWLS) (for intra- and inter-observer reproducibility, ICC = 0.670 and 0.749, respectively). FWLS and global longitudinal strain (GLS) showed moderate to strong positive correlation with FAC, TAPSE, and S' (correlation coefficients from 0.667 to 0.721).
It is feasible to assess RV strain across multiple platforms in a reproducible and reliable fashion. Furthermore, RV strain demonstrated good correlation with conventional RV functional parameters, suggesting its feasibility as a sensitive RV function assessment tool.
测试使用供应商中立平台评估右心室(RV)应变的可行性和可靠性。通过比较RV应变评估中观察者内和观察者间的变异性来确定可靠性。次要目的是评估应变与传统RV功能参数的相关性,以评估其作为RV收缩功能评估工具的可行性。
这是一项回顾性研究。
三级医院。
共纳入15例接受择期冠状动脉旁路移植手术的患者。
无。
使用供应商中立软件评估常规术中二维经食管超声心动图(2D TEE)期间获得的图像的纵向应变(LS)和传统参数,包括面积变化分数(FAC)、三尖瓣环平面收缩期位移(TAPSE)、多普勒组织成像(DTI)得出的三尖瓣侧环收缩期速度波(S')和RV尺寸。除基底游离壁纵向应变(FWLS)外(观察者内和观察者间的再现性,组内相关系数[ICC]分别为0.670和0.749),观察者内和观察者间的再现性良好至优秀(ICC为0.75至1.00)。FWLS和整体纵向应变(GLS)与FAC、TAPSE和S'呈中度至强正相关(相关系数为0.667至0.721)。
以可重复和可靠的方式跨多个平台评估RV应变是可行的。此外,RV应变与传统RV功能参数显示出良好的相关性,表明其作为敏感的RV功能评估工具的可行性。