• Shaun R Yockelson, Stephen B Heitner, Sarah Click, Gemechu Geleto, Miriam M Treggiari, and Michael P Hutchens.
• Department of Anesthesiology and Perioperative Medicine, Oregon Health and Science University, Portland, OR; Department of Anesthesiology, Ochsner Medical Center, New Orleans, LA. Electronic address: shaun.yockelson@gmail.com.
• J. Cardiothorac. Vasc. Anesth. 2019 Mar 1; 33 (3): 725-731.

ObjectiveAn association between central venous pressure and acute kidney injury (AKI) has been observed following cardiac surgery, but it is unknown whether this reflects intravascular volume status or impaired right ventricular (RV) myocardial performance. This study was performed to test the hypothesis that decreased RV peak longitudinal strain (PLSS), as measured by 2-dimensional speckle-tracking echocardiography, is associated with AKI following cardiac surgery.DesignRetrospective observational cohort study.SettingCardiovascular intensive care unit in a 576-bed referral hospital.ParticipantsAdult patients having undergone cardiac surgery in whom a transthoracic echocardiogram (TTE) was performed within 48 hours after chest closure.InterventionsThis was a retrospective study. Urine output and serum creatinine values were recorded at baseline and for 48 hours after surgery. Statistical analysis was performed to identify differences in baseline demographic and echo-derived values between patients with and without postoperative AKI criteria.Measurements And Main ResultsOne hundred ninety-nine subjects had postprocessing of TTE performed. AKI was observed in 87% of patients (173 of 199). Age, body mass index, and preoperative serum creatinine were higher in the AKI group. The mean PLSS was -17.2% ± 4.3% versus -17.1% ± 3.7% in patients with AKI versus those without (p = 0.95). The calculated RV systolic pressure was elevated in the AKI group compared to the non-AKI group (38.9 ± 9.9 v 34.6 ± 7.9 mmHg, p = 0.02).ConclusionIn this cohort of cardiac surgery patients, speckle-tracking analysis of RV myocardial performance was feasible. Elevated RV systolic pressure associated with AKI, while speckle tracking-derived echocardiography measurements did not.Copyright © 2018 Elsevier Inc. All rights reserved.

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