Preoperative Three-Dimensional Strain Imaging Identifies Reduction in Left Ventricular Function and Predicts Outcomes After Cardiac Surgery

Howard‐Quijano, Kimberly; Salem, Ali; Barkulis, Charles T.; Mazor, Einat; Scovotti, Jennifer; Ho, Jonathan K.; Shemin, Richard J.; Grogan, Tristan; Elashoff, David; Mahajan, Aman

doi:10.1213/ane.0000000000001440

Cited by 22 publications

(18 citation statements)

References 36 publications

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“…In asymptomatic patients with moderate-severe aortic regurgitation, it was found that 3D global circumferential strain compensates for the reduction in 3D longitudinal strain for preserving the LVEF (56). Further supporting the clinical use of 3DSTE, 3D strain was reported to be an independent predictor of acute and long-term clinical outcomes after cardiac surgery (57). 3DSTE was feasible, reproducible and time saving for assessing LV systolic function in patients before and after transcatheter aortic valve implantation (58).…”

Section: Aortic Valve Diseasesmentioning

confidence: 88%

Three-dimensional speckle-tracking echocardiography: benefits and limitations of integrating myocardial mechanics with three-dimensional imaging

Muraru¹,

Niero²,

Rodríguez‐Zanella³

et al. 2018

Cardiovasc. Diagn. Ther.

200

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Three-dimensional (3D) speckle-tracking echocardiography (3DSTE) is an advanced imaging technique designed for left ventricular (LV) myocardial deformation analysis based on 3D data sets. 3DSTE has the potential to overcome some of the intrinsic limitations of two-dimensional STE (2DSTE) in the assessment of complex LV myocardial mechanics, offering additional deformation parameters (such as area strain) and a comprehensive quantitation of LV geometry and function from a single 3D acquisition. Albeit being a relatively young technique still undergoing technological developments, several experimental studies and clinical investigations have already demonstrated the reliability and feasibility of 3DSTE, as well as several advantages of 3DSTE over 2DSTE. This technique has provided new insights into LV mechanics in several clinical fields, such as the objective assessment of global and regional LV function in ischemic and non-ischemic heart diseases, the evaluation of LV mechanical dyssynchrony, as well as the detection of subclinical cardiac dysfunction in cardiovascular conditions at risk of progression to overt heart failure. However, 3DSTE generally requires patient's breathhold and regular rhythm for enabling an ECG-gated multi-beat 3D acquisition. In addition, the measurements, normal limits and cut-off values pertaining to 3D strain parameters are currently vendor-specific and highly dependent on the 3D ultrasound equipment used. Technological advances with improvement in spatial and temporal resolution and a standardized methodology for obtaining vendor-independent 3D strain measurements are expected in the future for a widespread application of 3DSTE in both clinical and research arenas. The purpose of this review is to summarize currently available data on 3DSTE methodology (feasibility, accuracy and reproducibility), strengths and weaknesses with respect to 2DSTE, as well as the main clinical applications and future research priorities of this emerging technology.

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Section: Aortic Valve Diseasesmentioning

confidence: 88%

Three-dimensional speckle-tracking echocardiography: benefits and limitations of integrating myocardial mechanics with three-dimensional imaging

Muraru¹,

Niero²,

Rodríguez‐Zanella³

et al. 2018

Cardiovasc. Diagn. Ther.

200

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“…Prior studies using preoperative and postoperative 3D strain measures demonstrate a reduction in LV function immediately after cardiac surgery. 10,12 In our study, we also provided information from two more time points, which are before and after grafting to further define when the LV function begins to change. There is a study reported that only excessive anterior motion of the posterior wall can be seen and overall LV function is not affected with changes in pericardial restraint after valvular and CABG surgery.…”

Section: Intraoperative Monitoring Of LV Performancementioning

confidence: 99%

“…The superiority of 3D STE over conventional 2D parameters has been shown when analyzing the complexity of LV mechanics. 12,32 But this technique requires offline analysis. Advances in 3D STE may overcome this limitation and help it step into clinical practice better.…”

Section: Limitationsmentioning

confidence: 99%

Acute changes of left ventricular function during surgical revascularization by 3D speckle tracking

et al. 2021

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Left ventricular (LV) systolic function is a powerful predictor for the outcome of cardiac surgery patients. 1 In recent years, more attention has been paid to a brand-new heart failure phenotype, 2 as evidence of recovered ejection fraction (EF) and significant clinical improvement. However, there is a large cohort of patients with normal or near-normal EF undergoing coronary artery bypass grafting (CABG) surgery. 3 LVEF is less sensitive to detect myocardial improvement and limited to characterize regional function. Not only this, but also the impact of CABG on LV function has remained uncertain and controversial, [3][4][5][6] particularly involving changes of LV performance and the time course of functional recovery. Some studies reported that LV function recovered within weeks postoperatively, 7,8 while others detected no improvement or even deterioration. 9 Thus, more attractive echocardiographic indices are warranted to evaluate the effects of surgical revascularization on global and regional LV function.

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“…Three-dimensional strain and strain rate as parameters of myocardial deformation for the assessment of the left ventricle, right ventricle, and left atrium will play an important role in chamber quantification in the future [ 77 , 78 •].…”

Section: Cardiac Surgery and Three-dimensional Echocardiographymentioning

confidence: 99%

Role of 3D Echocardiography in Cardiac Surgery: Strengths and Limitations

Turton

Ender

2017

Curr Anesthesiol Rep

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Purpose of ReviewThis review aims to highlight the general and specific strengths and limitations of intraoperative 3D echocardiography. This article explains the value of real-time three-dimensional transesophageal echocardiography (RT 3D TEE) during cardiac surgery and cardiac interventions.Recent FindingsRecently published recommendations and guidelines include the use of RT 3D TEE. RT 3 D TEE provides additional value particularly for guidance during cardiac interventions (i.e., transcatheter mitral valve repair, left atrial appendix and atrial septal defect closures), assessment of the mitral valve in surgical repair, measurement of left ventricular outflow tract area for transcatheter valvular replacements, and estimating right and left ventricular volumes and function. The exact localization of paravalvular leakage is another strength of RT 3D TEE. The major limitation is the reduced temporal resolution compared to 2D TEE.SummaryThree-dimensional echocardiography is a powerful tool that improves communication and accurate measurements of cardiac structures.

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Preoperative Three-Dimensional Strain Imaging Identifies Reduction in Left Ventricular Function and Predicts Outcomes After Cardiac Surgery

Cited by 22 publications

References 36 publications

Three-dimensional speckle-tracking echocardiography: benefits and limitations of integrating myocardial mechanics with three-dimensional imaging

Three-dimensional speckle-tracking echocardiography: benefits and limitations of integrating myocardial mechanics with three-dimensional imaging

Acute changes of left ventricular function during surgical revascularization by 3D speckle tracking

Role of 3D Echocardiography in Cardiac Surgery: Strengths and Limitations

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