Effects of antegrade versus integrated blood cardioplegia on left ventricular function evaluated by echocardiographic real-time 3-dimensional speckle tracking

Bhaya, Maneesha; Sudhakar, Selvin; Sadat, Kamel; Beniwal, Rajesh; Joshi, Deepak; George, James F.; Nanda, Navin C.; Athanasuleas, Constantine L.

doi:10.1016/j.jtcvs.2014.11.034

Cited by 16 publications

(6 citation statements)

References 37 publications

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“…It is well known that septum dysfunction is commonplace after cardiac surgery, as 43% of 3292 patients [ 105 ] develop septal paradoxical motion (lesser damage was not reported). Impaired myocardial protection causes this injury, but this damage can be avoided [ 128 ], as undamaged hearts show improved longitudinal helical deformation [ 129 ].…”

Section: Diastolic Dysfunctionmentioning

confidence: 99%

What Is the Heart? Anatomy, Function, Pathophysiology, and Misconceptions

Nanda

Nguyen

Kočica³

2018

JCDD

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Cardiac dynamics are traditionally linked to a left ventricle, right ventricle, and septum morphology, a topography that differs from the heart’s five-century-old anatomic description of containing a helix and circumferential wrap architectural configuration. Torrent Guasp’s helical ventricular myocardial band (HVMB) defines this anatomy and its structure, and explains why the heart’s six dynamic actions of narrowing, shortening, lengthening, widening, twisting, and uncoiling happen. The described structural findings will raise questions about deductions guiding “accepted cardiac mechanics”, and their functional aspects will challenge and overturn them. These suppositions include the LV, RV, and septum description, timing of mitral valve opening, isovolumic relaxation period, reasons for torsion/twisting, untwisting, reasons for longitudinal and circumferential strain, echocardiographic sub segmentation, resynchronization, RV function dynamics, diastolic dysfunction’s cause, and unrecognized septum impairment. Torrent Guasp’s revolutionary contributions may alter future understanding of the diagnosis and treatment of cardiac disease.

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Section: Diastolic Dysfunctionmentioning

confidence: 99%

What Is the Heart? Anatomy, Function, Pathophysiology, and Misconceptions

Nanda

Nguyen

Kočica³

2018

JCDD

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“…Three‐dimensional speckle‐tracking imaging (3DSTI) can track the motion of the speckles in a real time and angle‐independent manner and thus can evaluate left ventricular (LV) function more comprehensively and accurately . However, the role of 3DSTI, two‐dimensional echocardiography (2DE), and magnetic resonance imaging (MRI) in detecting left ventricular ejection fraction (LVEF) in patients with primary dilated cardiomyopathy (DCM) remains controversial.…”

Section: Introductionmentioning

confidence: 99%

Value of three‐dimensional speckle‐tracking imaging in detecting left ventricular systolic function in patients with dilated cardiomyopathy

Yang

2019

Echocardiography

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Objective To explore the value of three‐dimensional speckle‐tracking imaging (3DSTI) in detecting left ventricular systolic function in patients with dilated cardiomyopathy (DCM). Methods Totally 31 DCM patients were enrolled in this study. Left ventricular end‐systolic volume (LVESV), left ventricular end‐diastolic volume (LVEDV), and left ventricular ejection fraction (LVEF) were measured using the 3DSTI, two‐dimensional echocardiography (2DE), and magnetic resonance imaging (MRI). Left ventricular end‐diastolic mass (EDmass) and left ventricular end‐diastolic mass index (LVEDmass I) were also detected by 3DSTI and MRI. The differences in these measurements were analyzed and compared. Results The values of LVESV, LVEDV, and LVEF showed significantly positive correlations among 2DE group, 3DSTI group, and MRI group. The LVEF value showed significant difference among these three groups [(33.3 ± 11.1)%, (30.3 ± 10.6)%, and (26.2 ± 10.7)%; P = 0.04], whereas LVEDV and LVESV values were not significantly different (P > 0.05; respectively). Inter‐group comparison showed the mean of LVEF was significantly lower in MRI group than in 2DE group (P = 0.031), whereas there was no significant difference between 2DE group and 3DSTI group and between 3DSTI group and MRI group (P > 0.05; respectively). The EDmass and EDmassI detected by 3DSTI and MRI were (143.2 ± 40.2) g vs (190.0 ± 58.3) g and (83.2 ± 21.1) g/m2 vs (110.1 ± 29.7) g/m2 (P < 0.001; respectively). Conclusions The LVEF value detected by 3DSTI is closer to that detected by MRI in DCM patients.

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“…It has been proposed that septal dysfunction after cardiac surgery is related to inadequate myocardial protection and that it can be prevented by specific cardioplegic techniques. 16 We have also shown that antegrade cardioplegia alone caused reduction in longitudinal strain, a variable that was normal after integrated antegrade and retrograde cardioplegia. The uninjured septum prevents RV dysfunction.…”

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confidence: 62%

Preoperative right ventricular dysfunction should not preclude surgical ventricular restoration

Athanasuleas

2017

The Journal of Thoracic and Cardiovascular Surgery

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Effects of antegrade versus integrated blood cardioplegia on left ventricular function evaluated by echocardiographic real-time 3-dimensional speckle tracking

Abstract: These findings by 3-dimensional transthoracic speckle tracking echocardiography indicate that integrated cardioplegia offers superior myocardial protection of the left ventricular free wall and septum compared with the antegrade mode of cardioplegia delivery.

Cited by 16 publications

References 37 publications

What Is the Heart? Anatomy, Function, Pathophysiology, and Misconceptions

What Is the Heart? Anatomy, Function, Pathophysiology, and Misconceptions

Value of three‐dimensional speckle‐tracking imaging in detecting left ventricular systolic function in patients with dilated cardiomyopathy

Preoperative right ventricular dysfunction should not preclude surgical ventricular restoration

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