• Shayne Michael Roberts, John Klick, Adrian Fischl, Tonya S King, and Theodore J Cios.
• Department of Anesthesiology and Perioperative Medicine, Penn State Health Milton S Hershey Medical Center, Hershey, PA. Electronic address: Sroberts4@pennstatehealth.psu.edu.
• J. Cardiothorac. Vasc. Anesth. 2020 May 1; 34 (5): 1252-1259.

ObjectivesTo assess the concordance between transesophageal echocardiographic (TEE) and transthoracic echocardiograpic (TTE) measures of right ventricular (RV) function using standard 2-dimensional and Doppler methods. The authors hypothesized that there would be significant disagreement in tricuspid annular plane systolic excursion (TAPSE), fractional area change, right-sided index of myocardial performance, and tricuspid annular systolic velocity (S').DesignProspective observational.SettingCardiac operating room at a single academic medical center.ParticipantsAll adult patients undergoing elective cardiac surgery at a single tertiary care academic medical center over 6 months.InterventionsNone.Measurements And Main ResultsThe fractional area change, S', TAPSE, right-sided index of myocardial performance, and tricuspid annular diameter were measured with TEE and TTE to assess for concordance using the concordance correlation coefficient and paired t tests, including 95% confidence limits. The study demonstrated that quantitative measures of RV function by TEE correlate poorly with TTE measurements in close temporal proximity under similar hemodynamic conditions.ConclusionsWhen performing an assessment of RV function, transesophageal echocardiographers should exercise caution when extrapolating data validated by TTE to TEE studies. Measures of RV function by TEE tend to have fair agreement to TTE measurements obtained in close temporal proximity under similar hemodynamic conditions. Most importantly, the present study showed that TAPSE and S' values obtained from the modified transgastric RV inflow view tend to have lower values than those measured with TTE. Given the propensity for underestimating measurements from the modified transgastric RV inflow view, the authors conclude that values equal to or greater than established norms for tricuspid annular motion may be used to establish normal-but not abnormal-RV function.Copyright © 2019 Elsevier Inc. All rights reserved.

14 keywords...

hide…