• Alok Kumar, Goverdhan Dutt Puri, and Ajay Bahl.
• Department of Anaesthesia & Intensive Care, Post Graduate Institute of Medical Education & Research, Chandigarh, India. Electronic address: docsomi@yahoo.com.
• J. Cardiothorac. Vasc. Anesth. 2017 Oct 1; 31 (5): 1695-1701.

ObjectiveSpeckle tracking, when combined with 3-dimensional (3D) left ventricular ejection fraction, might prove to be a more sensitive marker for postoperative ventricular dysfunction. This study investigated early outcomes in a cohort of patients with left ventricular dysfunction undergoing cardiac surgery.DesignProspective, blinded, observational study.SettingUniversity hospital; single institution.ParticipantsThe study comprised 73 adult patients with left ventricular ejection fraction <50% undergoing cardiac surgery using cardiopulmonary bypass.InterventionsRoutine transesophageal echocardiography before and after bypass.Measurements And Main ResultsGlobal longitudinal strain using speckle tracking and 3D left ventricular ejection fraction were computed using transesophageal echocardiography. Mean prebypass global longitudinal strain and 3D left ventricle ejection fraction were significantly lower in patients with postoperative low-cardiac-output syndrome compared with patients who did not develop low cardiac output (global longitudinal strain -7.5% v -10.7% and 3D left ventricular ejection fraction 29% v 39%, respectively; p < 0.0001). The cut-off value of global longitudinal strain predicting postoperative low-cardiac-output syndrome was -6%, with 95% sensitivity and 68% specificity; and 3D left ventricular ejection fraction was 19% with 98% sensitivity and 81% specificity.ConclusionsPreoperative left ventricular global longitudinal strain (-6%) and 3D left ventricular ejection fraction (19%) together could act as predictor of postoperative low-cardiac-output states with high sensitivity (99.9%) in patients undergoing cardiac surgery.Copyright © 2017 Elsevier Inc. All rights reserved.

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