Department of Cardiology, Faculty of Medicine, Cairo University, Cairo, Egypt.
Echocardiography. 2021 Jun;38(6):892-900. doi: 10.1111/echo.15072. Epub 2021 May 11.
Transthoracic echocardiography (TTE) in prone position is challenging. Innovative use of transesophageal echocardiography (TEE) probe to perform TTE for such patients has been described; but reproducibility and correlation of the TTE measurements by this technique with those obtained by the standard supine TTE study are still unknown.
We enrolled 30 non-COVID-19 individuals, with a mean (SD) age 35 (10.9) years and 11 females, to study the agreement between the transthoracic measurements of the left ventricular (LV), left atrial (LA), aortic dimensions, and ejection fraction (EF) obtained in prone position using an external TEE probe versus the standard supine position using the conventional TTE probe.
There were no significant differences between LV end-diastolic and end-systolic diameters, septal wall thickness, posterior wall thickness, and aortic root dimensions in the prone versus the supine positions, while the mean EF (60.3% vs 63.1%, P = .014) and mean LA dimensions (1.8 vs 1.9 cm/m , P < .001) were significantly lower in the prone position. The mean time of scans was significantly longer in the prone as compared to the supine position (12.5 vs 4.5 minutes, P < .001). All supine studies had good quality while in the prone position four studies were of poor quality, and one was nondiagnostic.
Assessment of cardiac dimensions and systolic function in the prone position using transthoracic TEE probe was feasible. LV and aortic dimensions agreed well with the standard TTE in supine position; however, LA dimensions and EF were lower in the prone position.
经胸超声心动图(TTE)在俯卧位时具有挑战性。已经描述了创新性地使用经食管超声心动图(TEE)探头为这类患者进行 TTE;但这种技术获得的 TTE 测量值与标准仰卧位 TTE 研究获得的 TTE 测量值的可重复性和相关性仍不清楚。
我们纳入了 30 名非 COVID-19 个体,平均(SD)年龄为 35(10.9)岁,女性 11 名,研究使用外部 TEE 探头在俯卧位获得的左心室(LV)、左心房(LA)、主动脉尺寸和射血分数(EF)的 TTE 测量值与使用常规 TTE 探头在标准仰卧位获得的测量值之间的一致性。
在俯卧位与仰卧位时,LV 舒张末期和收缩末期直径、室间隔厚度、后壁厚度和主动脉根部尺寸之间无显著差异,而平均 EF(60.3% 对 63.1%,P=0.014)和平均 LA 尺寸(1.8 对 1.9cm/m,P<0.001)在俯卧位时显著更低。与仰卧位相比,俯卧位的扫描时间明显更长(12.5 对 4.5 分钟,P<0.001)。所有仰卧位研究的质量都很好,而在俯卧位时,有 4 项研究的质量较差,有 1 项研究无法诊断。
使用经胸 TEE 探头在俯卧位评估心脏尺寸和收缩功能是可行的。LV 和主动脉尺寸与标准仰卧位 TTE 一致良好;然而,LA 尺寸和 EF 在俯卧位时较低。