Interchangeability of right ventricular longitudinal shortening fraction assessed by transthoracic and transoesophageal echocardiography in the perioperative setting: A prospective study

Abstract

BackgroundConventional transthoracic (TTE) and transoesophageal echocardiography (TEE) parameters assessing right ventricle (RV) systolic function are daily used assuming their clinical interchangeability. RV longitudinal shortening fraction (RV-LSF) is a two-dimensional speckle tracking parameter used to assess RV systolic function. RV-LSF is based on tricuspid annular displacement analysis and could be measured with TTE or TEE.ObjectiveThe aim of the study was to determine if RV-LSFTTE and RV-LSFTEE measurements were interchangeable in the perioperative setting.MethodsProspective perioperative TTE and TEE echocardiography were performed under general anesthesia during scheduled cardiac surgery in 90 patients. RV-LSF was measured by semi-automatic software. Comparisons were performed using Pearson correlation and Bland-Altman plots. RV-LSF clinical agreement was determined as a range of −5 to 5%.ResultsOf the 114 patients who met the inclusion criteria, 90 were included. The mean preoperative RV-LSFTTE was 20.4 ± 4.3 and 21.1 ± 4.1% for RV-LSFTEE. The agreement between RV-LSF measurements was excellent, with a bias at −0.61 and limits of agreement of −4.18 to 2.97 %. All measurements fell within the determined clinical agreement interval in the Bland-Altman plot. Linear regression analysis showed a high correlation between RV-LSFTTE and RV-LSFTEE measurement (r = 0.9; confidence interval [CI] 95%: [0.87–0.94], p < 0.001).ConclusionRV-LSFTTE and RV-LSFTEE measurements are interchangeable, allowing RV-LSF to be a helpful parameter for assessing perioperative changes in RV systolic function.NCTNCT05404737. https://www.clinicaltrials.gov/ct2/show/NCT05404737.

Speckle-Tracking Echocardiography in Right Ventricular Function of Clinically Well Patients with Heart Transplantation

“…Second, further research is also needed to confirm the prognostic value of STE strain parameters in such a population, as the number of studies focusing on this was relatively small. Third, the primary limitation of STE strain analysis is its intrinsic requirement for good picture quality, which has not been adequately addressed thus far [ 71 , 72 , 73 , 74 , 75 ]. Additional research is necessary to maximize its clinical application.…”

Current trends and latest developments in echocardiographic assessment of right ventricular function: load dependency perspective

“…Although the EACVI/ASE Joint Task Force recommendations emphasize analysis in the RV-focused four-chamber view ( 15 ), studies have demonstrated that RV strain values from subcostal views are highly correlated with those from the apical view (Pearson's r = 0.89) in 94 cases with veno-venous (V-V) ECMO ( 50 ). RV strain values from the four-chamber view using transesophageal echocardiography also showed a high correlation with those from the RV-focused four-chamber view using transthoracic echocardiography ( r = 0.9; 95% CI 0.87–0.94) ( 51 ).…”