Document Detail

Echocardiographic assessment of right ventricular systolic function in a population of unselected patients before cardiac surgery: A multiparametric approach is necessary.
MedLine Citation:
PMID:  25218010     Owner:  NLM     Status:  Publisher    
BACKGROUND: According to recent USA guidelines, right ventricular (RV) dysfunction can be diagnosed on the basis of a single parameter, such as tricuspid lateral annular systolic velocity (S')<10cm/s or RV fractional area change (RVFAC)<35%.
AIMS: To assess these recommendations in a large unselected cohort of patients awaiting cardiac surgery and evaluate less validated RV function criteria.
METHODS: Among the consecutive patients, 413 were prospectively enrolled and underwent comprehensive echocardiography, including S', RVFAC and other RV parameters (right myocardial performance index; acceleration time, isovolumic velocity and isovolumic acceleration [IVA]; RV dP/dt; isovolumic relaxation time; two-dimensional [2D] strain). We defined subgroups of highly probable RV dysfunction (S'<10cm/s and RVFAC<35%) and highly probable normal RV function (S'≥10cm/s and RVFAC≥35%) as reference groups. Indices of preload and afterload were also recorded.
RESULTS: Of 413 patients, 320 (77.5%) had normal RV function. In 93 patients, S' and/or RVFAC were abnormal; both were abnormal in 39 (42%) patients. Using our reference groups, IVA≤1.8m/s(2) and basal 2D strain≥-17% were of most value in diagnosing RV dysfunction. IVA was least load dependent while basal 2D strain appeared to be afterload and preload dependent.
CONCLUSION: In this large population, S' and RVFAC were sometimes discrepant, supporting the need for a multiparametric approach when evaluating RV function. Among seven less validated criteria, IVA and 2D strain had the best diagnostic value. Unlike 2D strain, IVA was not influenced by loading conditions.
Jérôme Peyrou; Chirine Parsaï; Christophe Chauvel; Marc Simon; Patrick Dehant; Eric Abergel
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-9-10
Journal Detail:
Title:  Archives of cardiovascular diseases     Volume:  -     ISSN:  1875-2128     ISO Abbreviation:  Arch Cardiovasc Dis     Publication Date:  2014 Sep 
Date Detail:
Created Date:  2014-9-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101465655     Medline TA:  Arch Cardiovasc Dis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 Elsevier Masson SAS. All rights reserved.
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