Correlation of echocardiographic parameters in prone and supine positions in normal adults using a novel approach

Abstract

Background: 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. Methods: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.Results: There were no significant differences between LV end-diastolic and endsystolic 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 2 , 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.Conclusions: 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.

Transthoracic echocardiography of patients in prone position ventilation during the COVID-19 pandemic: an observational and retrospective study

“…In those circumstances, a TEE assessment is recommended given the improvement in quality image [ 10 ]. Nevertheless, its implementation has inherent difficulties that were accentuated by the COVID-19 pandemic: the probe is not available in many of the ICUs, a TEE trained physician is needed, has higher risk of aerosol generation, and require high workload including proper equipment sterilization and longer exposure to the patient’s infected particles [ 9 , 11 , 18 ].…”

Echocardiography in Prone Positioned Critically Ill Patients: A Wealth of Information from a Single View

“…A novel approach was proposed by Marvaki et al [ 14 ] and Taha et al [ 17 ]; in fact, they used a TEE probe to obtain traditional TTE windows in prone position. Taha et al found that all the measurements of the LVEDD, LVESD, SWT, PWT, and AoR dimensions in the prone position were accurate and replicated the corresponding measurements in the supine position well.…”