The use of echocardiographic indices in defining and assessing right ventricular systolic function in critical care research

Huang, Stephen; Nalos, Marek; Smith, Louise; Rajamani, Arvind; McLean, Anthony S.

doi:10.1007/s00134-018-5211-z

Cited by 32 publications

(43 citation statements)

References 107 publications

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“…Moreover, in ICU, adequate acoustic window is often impaired by mechanical ventilation and suboptimal patient positioning [8]. These obstacles, as well as the predominance of longitudinal-oriented muscle fibres, have led to the widespread use of parameters that estimate RV function based only on its lateral wall longitudinal motion (such as TAPSE or S′) [9]. Indices that measure the global function (such as RV FAC) have been shown to have lower feasibility [7].…”

Section: Discussionmentioning

confidence: 99%

“…To date, there are no gold standard echocardiographic indices for RV function assessment. Many indices are available, with their own strengths and limitations [9]. Furthermore, for each index, there is no definite cutoff value to define RV dysfunction, especially in ventilated ICU patients in whom load conditions and positive-pressure ventilation can substantially alter "normal" values.…”

Section: Table 4 Correlation Coefficients (Pearson) Between Echocardimentioning

confidence: 99%

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Feasibility, reproducibility and diagnostic usefulness of right ventricular strain by 2-dimensional speckle-tracking echocardiography in ARDS patients: the ARD strain study

Lemarié¹,

Maigrat

Kimmoun³

et al. 2020

Ann. Intensive Care

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Background: Right ventricular (RV) function evaluation by echocardiography is key in the management of ICU patients with acute respiratory distress syndrome (ARDS), however, it remains challenging. Quantification of RV deformation by speckle-tracking echocardiography (STE) is a recently available and reproducible technique that provides an integrated analysis of the RV. However, data are scarce regarding its use in critically ill patients. The aim of this study was to assess its feasibility and clinical usefulness in moderate-severe ARDS patients.Results: Forty-eight ARDS patients under invasive mechanical ventilation (MV) were consecutively enrolled in a prospective observational study. A full transthoracic echocardiography was performed within 36 h of MV initiation. STE-derived and conventional parameters were recorded. Strain imaging of the RV lateral, inferior and septal walls was highly feasible (47/48 (98%) patients). Interobserver reproducibility of RV strain values displayed good reliability (intraclass correlation coefficients (ICC) > 0.75 for all STE-derived parameters) in ARDS patients. ROC curve analysis showed that lateral, inferior, global (average of the 3 RV walls) longitudinal systolic strain (LSS) and global strain rate demonstrated significant diagnostic values when compared to several conventional indices (TAPSE, S′, RV FAC). A RV global LSS value > − 13.7% differentiated patients with a TAPSE < vs > 12 mm with a sensitivity of 88% and a specificity of 83%. Regarding clinical outcomes, mortality and cumulative incidence of weaning from MV at day 28 were not different in patients with normal versus abnormal STE-derived parameters. Conclusions:Global STE assessment of the RV was highly achievable and reproducible in moderate-severe ARDS patients under MV and additionally correlated with several conventional parameters of RV function. In our cohort, STE-derived parameters did not provide any incremental value in terms of survival or weaning from MV prediction. Further investigations are needed to evaluate their theranostic usefulness. Trial registration NCT02638844: NCT

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Section: Discussionmentioning

confidence: 99%

Section: Table 4 Correlation Coefficients (Pearson) Between Echocardimentioning

confidence: 99%

Feasibility, reproducibility and diagnostic usefulness of right ventricular strain by 2-dimensional speckle-tracking echocardiography in ARDS patients: the ARD strain study

Lemarié¹,

Maigrat

Kimmoun³

et al. 2020

Ann. Intensive Care

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“…The maximum longitudinal excursion of the lateral tricuspidal annulus is measured in M-mode in an apical 4-chamber view between the end of the systole and the end of the diastole. A TAPSE >16 mm correlates well with normal RV function; abnormal TAPSE suggests poor clinical outcome in several pathologies, such as ARDS, pulmonary embolism and sepsis [36].…”

Section: Case-echocardiographymentioning

confidence: 95%

“…Pulsed (PW) Doppler measurements quantify velocities at certain points, whereas continuous (CW) Doppler measurements enable quantification of the overall flow velocity. Thus, cardiac output can be calculated from the integral of the LV outflow velocity time (LVOT-VTI) and the aortic valve opening area (AVA) [36].…”

Section: Assessment Of Left Ventricular Systolic Functionmentioning

confidence: 99%

Modern diagnostics in emergency medicine

Niederdöckl

Buchtele

Schwameis

et al. 2020

Wien Klin Wochenschr

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“…Only 8% of included reviews (n=3) [22,43,54] provided the explanations for individual changes in the published full text and thus were considered to improve the reporting quality. Inclusion of the terms "systematic reviews" and "Meta-analysis" in review title [33] [43] [49] Exclusion of the terms "systematic reviews" and 'Meta-analysis" from review title [40] [46] The key information (PICO) about the scope of the reviews was provided [ Deleting the principal summary measures (risk ratio, difference in means, etc. )/the methods of handling data and combining results of studies (including measures of consistency for each meta-analysis)/the assessment of risk of bias that may affect the…”

Section: Categories and Impact Of Changes In Each Sectionmentioning

confidence: 99%

Inconsistencies are common between non-Cochrane systematic reviews and their protocols registered in the International prospective register of systematic reviews (PROSPERO) but were seldom explained

Hu¹,

Zhang²,

Zhang³

et al. 2020

Preprint

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Background: Protocols of systematic reviews allow for planning and documentation of review methods and thus improve the transparency of the reviews process. However, pre-registration of a protocol is not enough, the author also need to follow it. PROSPERO is an open-access online database for the registration of non-Cochrane systematic reviews. The purpose of this study is to compare published non-Cochrane reviews with their pre-registered protocols on PROSPERO to determine what changes, if any, have been made, and how likely these changes are to impact the quality of systematic review. Methods: This is a retrospective comparative study. We searched for protocols on PROSPERO platform that were registered in 2018 and then selected the protocols that full text have been published as of January 1st 2019. Published full texts were identified through the protocol's final publication citation. Two authors independently compared and identified changes between protocols and systematic reviews and then evaluated the impact (improve, reduce, or unclear) of these changes on the reporting or methodology quality of reviews. Descriptive statistics of percentage (%) and frequency (n) were conducted. Results: We identified 39 pairs, all of which exhibited changes. “Search strategy”(92%, n=36), “data extraction”(90%, n=35), “data synthesis”(77%, n=30), “outcome”(64%, n=24), and “subgroup analysis”(64%, n=24) all showed significant changes. All changes to only one review were considered to improve the reporting or methodology quality, and the remaining 97% of reviews (n=38) contained changes that were considered to reduce the methodology or reporting quality or that had an unclear impact on systematic reviews. Conclusions: Changes between the non-Cochrane systematic reviews and their protocols recorded on PROSPERO were widespread. Some of the changes reduced the methodology or reporting quality of systematic reviews or had an unclear impact. Measures should be taken to further improve the transparency of the non-Cochrane systematic reviews. Adding a new item in updated “Preferred Reporting Items for Systematic reviews and Meta-Analyses” (PRISMA) and “Meta-analysis of Observational Studies in Epidemiology” (MOOSE) to guide reporting and explaining the changes, as well as advising peer reviewers (and editors) to check the reviews against the protocols are two suggested fundamental solutions.

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The use of echocardiographic indices in defining and assessing right ventricular systolic function in critical care research

Abstract: TAPSE seemed to be the most popular index in the last 2-3 years. Many studies used combinations of indices but, apart from cor pulmonale, we could not find a consistent pattern of RV assessment and definition of RV dysfunction amongst these studies.

Cited by 32 publications

References 107 publications

Feasibility, reproducibility and diagnostic usefulness of right ventricular strain by 2-dimensional speckle-tracking echocardiography in ARDS patients: the ARD strain study

Feasibility, reproducibility and diagnostic usefulness of right ventricular strain by 2-dimensional speckle-tracking echocardiography in ARDS patients: the ARD strain study

Modern diagnostics in emergency medicine

Inconsistencies are common between non-Cochrane systematic reviews and their protocols registered in the International prospective register of systematic reviews (PROSPERO) but were seldom explained

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