Feasibility of Right Ventricular Longitudinal Systolic Function Evaluation with Transthoracic Echocardiographic Indices Derived from Tricuspid Annular Motion: A Preliminary Study in Acute Respiratory Distress Syndrome

Fichet, Jérôme; Moreau, Laure; Genée, Olivier; Legras, Annick; Mercier, Emmanuelle; Garot, Denis; Dequin, Pierre‐François; Perrotin, D.

doi:10.1111/j.1540-8175.2011.01650.x

Cited by 38 publications

(40 citation statements)

References 30 publications

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“…[567891112131415161819202122] Three small studies reported incidence proportion more than 50%. [1213] However, majority of the studies reported an incidence proportion between 10% and 30%.…”

Section: Resultsmentioning

confidence: 99%

“…[1213] However, majority of the studies reported an incidence proportion between 10% and 30%. [567891112131415161819202122] Sixteen estimates were included in the meta-analysis. The overall IVhet pooled incidence proportion of ACP was 23% (95% CIs = 18%–28%) with a high level of heterogeneity ( I 2 = 78%) [Figure 2].…”

Section: Resultsmentioning

confidence: 99%

“…[31] About 27%–48% patients with ARDS had TAPSE <16 mm while undergoing lung protective ventilation in five studies. [1214182021]…”

Section: Discussionmentioning

confidence: 99%

“…[56] Many recent studies showed that a large number of patients still suffered from RV dysfunction and its associated mortality despite being subjected to lung protective ventilation according to the current guidelines. [5678910111213141516171819202122] However, most of these studies had small sample size and reported varied incidence of ACP ranging from 10% to 84% across the literature. [5678910111213141516171819202122] This necessitated us to undertake this systematic review of cross-sectional or cohort studies on cumulative incidence of ACP in patients with ARDS subjected to lung protective ventilation.…”

Section: Introductionmentioning

confidence: 99%

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Incidence proportion of acute cor pulmonale in patients with acute respiratory distress syndrome subjected to lung protective ventilation: A systematic review and meta-analysis

Das¹,

Choupoo

Saikia

et al. 2017

Indian Journal of Critical Care Medicine

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Introduction:Reported incidence of acute cor pulmonale (ACP) in patients with acute respiratory distress syndrome (ARDS) varies from 10% to 84%, despite being subjected to lung protective ventilation according to the current guidelines. The objective of this review is to find pooled cumulative incidence of ACP in patients with ARDS undergoing lung protective ventilation.Materials and Methods:We searched MEDLINE, EMBASE, Cochrane Library, KoreaMed, LILACS, and WHO Clinical Trial Registry. Cross-sectional or cohort studies were included if they reported or provided data that could be used to calculate the incidence proportion of ACP. Inverse variance heterogeneity (IVhet) and random effect model were used for the main outcome and measures.Results:We included 16 studies encompassing 1661 patients. The cumulative incidence of ACP using IVhet analysis was 23% (95% confidence interval [CI] = 18%–28%) over 3 days of lung protective ventilation. Random effect analysis of 7 studies (1250 patients) revealed pooled odd ratio of mortality of 1.16 (95% CI = 0.80-1.67, P = 0.44) due to ACP.Conclusion:Patients with ARDS have a 23% risk of developing ACP with lung protective ventilation. Findings of this review indicate the need of updating existing guidelines for ventilating ARDS patients to incorporate right ventricle protective strategy.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…[31] About 27%–48% patients with ARDS had TAPSE <16 mm while undergoing lung protective ventilation in five studies. [1214182021]…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Incidence proportion of acute cor pulmonale in patients with acute respiratory distress syndrome subjected to lung protective ventilation: A systematic review and meta-analysis

Das¹,

Choupoo

Saikia

et al. 2017

Indian Journal of Critical Care Medicine

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“…We evaluated cardiac function and hemodynamics as potential determinants of BNP secretion by using both right heart catheterization and echocardiography. Moreover, we used a PAC equipped with a rapid response thermistor for the assessment of RV systolic function, as echocardiographic estimation of RV systolic function in mechanically ventilated ICU patients is considered problematic in terms of feasibility and reproducibility [49]. In addition, by comparing septic patients with hemorrhagic shock patients, we provide evidence that noradrenalin dose may not be a stimulus of BNP secretion per se .…”

Section: Discussionmentioning

confidence: 99%

New insights into the mechanisms involved in B-type natriuretic peptide elevation and its prognostic value in septic patients

et al. 2014

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IntroductionElevated plasma B-type natriuretic peptide (BNP) levels in patients with critical sepsis (severe sepsis and septic shock) may indicate septic cardiomyopathy. However, multiple heterogeneous conditions may also be involved in increased BNP level. In addition, the prognostic value of BNP in sepsis remains debatable. In this study, we sought to discover potential independent determinants of BNP elevation in critical sepsis. The prognostic value of BNP was also evaluated.MethodsIn this observational study, we enrolled mechanically ventilated, critically septic patients requiring hemodynamic monitoring through a pulmonary artery catheter. All clinical, laboratory and survival data were prospectively collected. Plasma BNP concentrations were measured daily for five consecutive days. Septic cardiomyopathy was assessed on day 1 on the basis of left and right ventricular ejection fractions (EF) derived from echocardiography and thermodilution, respectively. Mortality was recorded at day 28.ResultsA total of 42 patients with severe sepsis (N = 12) and septic shock (N = 30) were ultimately enrolled. Daily BNP levels were significantly elevated in septic shock patients compared with those with severe sepsis (P ≤0.002). Critical illness severity (assessed by Acute Physiology and Chronic Health Evaluation II and maximum Sequential Organ Failure Assessment scores), and peak noradrenaline dose on day 1 were independent determinants of BNP elevation (P <0.05). Biventricular EFs were inversely correlated with longitudinal BNP measurements (P <0.05), but not independently. Pulmonary capillary wedge pressures (PCWP) and volume expansion showed no correlation with BNP. In septic shock, increased central venous pressure (CVP) and CVP/PCWP ratio were independently associated with early BNP values (P <0.05).Twenty-eight-day mortality was 47.6% (20 of 42 patients). Daily BNP values poorly predicted outcome; BNP on day 1 > 800 pg/ml (the best cutoff point) fairly predicted mortality, with a sensitivity%, specificity% and area under the curve values of 65, 64 and 0.70, respectively (95% confidence interval = 0.54 to 0.86; P = 0.03). Plasma BNP levels declined faster in survivors than in nonsurvivors in both critical sepsis and septic shock (P ≤0.002). In septic shock, a BNP/CVP ratio >126 pg/mmHg/ml on day 2 and inability to reduce BNP <500 pg/ml implied increased mortality (P ≤0.036).ConclusionsThe severity of critical illness, rather than septic cardiomyopathy, is probably the major determinant of BNP elevation in patients with critical sepsis. Daily BNP values are of limited prognostic value in predicting 28-day mortality; however, fast BNP decline over time and a decrease in BNP <500 pg/ml may imply a favorable outcome.

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Tricuspid annular plane systolic excursion in pulmonary hypertension—Moving beyond the sector plane

Ichimura,

Celestin,

Bagherzadeh

et al. 2024

Pulm. circ.

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Tricuspid annular plane systolic excursion (TAPSE) is usually measured with M‐mode using sector line, however, this may not align with the anatomical shortening of the right ventricular (RV). In this study, we compared the different methods to measure TAPSE using three different reference lines (sector line, anatomical line, and apico‐annular line). We included 148 patients diagnosed with pulmonary arterial hypertension (PAH) who underwent TTE and right heart catheterization within 2 weeks of each other. TAPSE was measured by M‐mode (sector, anatomical), 2D (sector, anatomical), or as tricuspid apico‐annular displacement (TAAD). Agreement between measures was assessed using coefficient of variation (COV), Spearman's correlation, and Bland–Altman analysis. Receiver–operating characteristics and Kaplan–Meier analysis were used to explore associations with the combined outcome of death or lung transplantation at 5 years. There was a good concordance between anatomical and sector M‐mode with a COV of 15.5 ± 1.6% and a bias of −0.6 ± 3.2 mm. In contrast, anatomical M‐mode TAPSE and TAAD differed significantly with the mean difference of 3.3 ± 3.8 mm (COV 30.5 ± 6.1%; p < 0.0001). Among the different 2D methods, anatomical 2D agreed well with anatomical M‐mode TAPSE (COV of 11.8 ± 2.0%; r = 0.89; p < 0.0001). Among the five methods, TADD had the strongest association with the combined endpoint of death or transplantation at 5 years (C‐statistic 0.64, 95% confidence interval [CI] 0.57–0.71). We concluded that different measures of TAPSE are not interchangeable.

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Feasibility of Right Ventricular Longitudinal Systolic Function Evaluation with Transthoracic Echocardiographic Indices Derived from Tricuspid Annular Motion: A Preliminary Study in Acute Respiratory Distress Syndrome

Cited by 38 publications

References 30 publications

Incidence proportion of acute cor pulmonale in patients with acute respiratory distress syndrome subjected to lung protective ventilation: A systematic review and meta-analysis

Incidence proportion of acute cor pulmonale in patients with acute respiratory distress syndrome subjected to lung protective ventilation: A systematic review and meta-analysis

New insights into the mechanisms involved in B-type natriuretic peptide elevation and its prognostic value in septic patients

Tricuspid annular plane systolic excursion in pulmonary hypertension—Moving beyond the sector plane

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