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Evaluation of left and right ventricular myocardial function after lung resection using speckle tracking echocardiography.

Wang Z, Yuan J, Chu W, Kou Y, Zhang X - Medicine (Baltimore) (2016)

Bottom Line: STE was performed on both right and left ventricle (RV and LV).Comparison between the pneumonectomy group and the lobectomy group was also studied.Left ventricular ejection fraction remained normal (>55%), but significantly decreased after lung resection in both the pneumonectomy group and the lobectomy group.Strain values in the RV and LV decreased in both groups after lung resection, with the pneumonectomy group exhibiting a further decrease in longitudinal strain in LV and RV when compared with the lobectomy group (P < 0.05).Right and left ventricular dysfunction can occur after lung resection regardless of pneumonectomy or lobectomy, and lobectomy may have a less significant impact on myocardial functions.

View Article: PubMed Central - PubMed

Affiliation: aDepartment of Ultrasonography, The People's Hospital of Zhengzhou University, Zhengzhou bDepartment of Ultrasound, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang, Henan, China.

ABSTRACT
The impact of major lung resections on myocardial function has not been well-investigated. We aimed to identify this impact through the use of speckle tracking echocardiography (STE) to evaluate the right and left ventricular myocardial function in patients who underwent lung resections.Thirty patients who had lung resections were recruited for this study. Ten patients who underwent pneumonectomies were matched by age and sex, with 20 patients who underwent lobectomies. STE was performed on both right and left ventricle (RV and LV). Strain values of pre and postlung resections were compared in both the pneumonectomy group and the lobectomy group. Comparison between the pneumonectomy group and the lobectomy group was also studied.Left ventricular ejection fraction remained normal (>55%), but significantly decreased after lung resection in both the pneumonectomy group and the lobectomy group. An accelerated heart rate was observed in both groups after lung resection, with the pneumonectomy group demonstrating extra rapid heart rate (P < 0.05). Strain values in the RV and LV decreased in both groups after lung resection, with the pneumonectomy group exhibiting a further decrease in longitudinal strain in LV and RV when compared with the lobectomy group (P < 0.05).Right and left ventricular dysfunction can occur after lung resection regardless of pneumonectomy or lobectomy, and lobectomy may have a less significant impact on myocardial functions. This study demonstrated that STE is able to detect acute cardiac dysfunction after lung resection.

No MeSH data available.


Related in: MedlinePlus

Two-dimensional speckle tracking for strain values at both right and left ventricles. A, Circumferential strain derived from mitral valve level of right ventricle; B, radial strain derived from mitral valve level of right ventricle; C, longitudinal strain derived from apical 4-chamber view of right ventricle; D, longitudinal strain curves derived from apical 4 and 2-chamber view and apical long-axis view of left ventricle.
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Figure 2: Two-dimensional speckle tracking for strain values at both right and left ventricles. A, Circumferential strain derived from mitral valve level of right ventricle; B, radial strain derived from mitral valve level of right ventricle; C, longitudinal strain derived from apical 4-chamber view of right ventricle; D, longitudinal strain curves derived from apical 4 and 2-chamber view and apical long-axis view of left ventricle.

Mentions: Speckle tracking echocardiography was performed to assess myocardial strain during systole. Off-line analyses of strain values from archived image loops were performed using commercially available analysis software (Echopac, GE Vingmed). The region of interest (ROI) of the RV and left ventricle (LV) was defined by tracking the endocardial and epicardial borders (Fig. 2). The ROI width was adjusted as needed to fit the wall thickness, as previously described.[15–17] The tracking quality of each segment was indicated by the software, and the segments with insufficient tracking quality were excluded. Peak strain values at each segment and global strain were acquired. Myocardial strain values were analyzed by a single observer blinded to the clinical findings and other echocardiographic measurements. Right ventricular free wall and septal circumferential strain (CS) and radial strain (RS) were calculated from average value of different levels of short-axis views (Fig. 2A and B). Right ventricular free wall and septal longitudinal strain (LS) values were calculated from an average of 3 segments (basal, mid, and apical) at apical long-axis views (Fig. 2C). Left ventricular LS values were acquired from average values of apical long-axis view, and apical 4 and 2-chmaber views (Fig. 2D). CS and RS of LV were acquired from average values of different levels in short-axis views, whereas twist was calculated from the difference in rotation at apical and basal short-axis views.


Evaluation of left and right ventricular myocardial function after lung resection using speckle tracking echocardiography.

Wang Z, Yuan J, Chu W, Kou Y, Zhang X - Medicine (Baltimore) (2016)

Two-dimensional speckle tracking for strain values at both right and left ventricles. A, Circumferential strain derived from mitral valve level of right ventricle; B, radial strain derived from mitral valve level of right ventricle; C, longitudinal strain derived from apical 4-chamber view of right ventricle; D, longitudinal strain curves derived from apical 4 and 2-chamber view and apical long-axis view of left ventricle.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4979785&req=5

Figure 2: Two-dimensional speckle tracking for strain values at both right and left ventricles. A, Circumferential strain derived from mitral valve level of right ventricle; B, radial strain derived from mitral valve level of right ventricle; C, longitudinal strain derived from apical 4-chamber view of right ventricle; D, longitudinal strain curves derived from apical 4 and 2-chamber view and apical long-axis view of left ventricle.
Mentions: Speckle tracking echocardiography was performed to assess myocardial strain during systole. Off-line analyses of strain values from archived image loops were performed using commercially available analysis software (Echopac, GE Vingmed). The region of interest (ROI) of the RV and left ventricle (LV) was defined by tracking the endocardial and epicardial borders (Fig. 2). The ROI width was adjusted as needed to fit the wall thickness, as previously described.[15–17] The tracking quality of each segment was indicated by the software, and the segments with insufficient tracking quality were excluded. Peak strain values at each segment and global strain were acquired. Myocardial strain values were analyzed by a single observer blinded to the clinical findings and other echocardiographic measurements. Right ventricular free wall and septal circumferential strain (CS) and radial strain (RS) were calculated from average value of different levels of short-axis views (Fig. 2A and B). Right ventricular free wall and septal longitudinal strain (LS) values were calculated from an average of 3 segments (basal, mid, and apical) at apical long-axis views (Fig. 2C). Left ventricular LS values were acquired from average values of apical long-axis view, and apical 4 and 2-chmaber views (Fig. 2D). CS and RS of LV were acquired from average values of different levels in short-axis views, whereas twist was calculated from the difference in rotation at apical and basal short-axis views.

Bottom Line: STE was performed on both right and left ventricle (RV and LV).Comparison between the pneumonectomy group and the lobectomy group was also studied.Left ventricular ejection fraction remained normal (>55%), but significantly decreased after lung resection in both the pneumonectomy group and the lobectomy group.Strain values in the RV and LV decreased in both groups after lung resection, with the pneumonectomy group exhibiting a further decrease in longitudinal strain in LV and RV when compared with the lobectomy group (P < 0.05).Right and left ventricular dysfunction can occur after lung resection regardless of pneumonectomy or lobectomy, and lobectomy may have a less significant impact on myocardial functions.

View Article: PubMed Central - PubMed

Affiliation: aDepartment of Ultrasonography, The People's Hospital of Zhengzhou University, Zhengzhou bDepartment of Ultrasound, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang, Henan, China.

ABSTRACT
The impact of major lung resections on myocardial function has not been well-investigated. We aimed to identify this impact through the use of speckle tracking echocardiography (STE) to evaluate the right and left ventricular myocardial function in patients who underwent lung resections.Thirty patients who had lung resections were recruited for this study. Ten patients who underwent pneumonectomies were matched by age and sex, with 20 patients who underwent lobectomies. STE was performed on both right and left ventricle (RV and LV). Strain values of pre and postlung resections were compared in both the pneumonectomy group and the lobectomy group. Comparison between the pneumonectomy group and the lobectomy group was also studied.Left ventricular ejection fraction remained normal (>55%), but significantly decreased after lung resection in both the pneumonectomy group and the lobectomy group. An accelerated heart rate was observed in both groups after lung resection, with the pneumonectomy group demonstrating extra rapid heart rate (P < 0.05). Strain values in the RV and LV decreased in both groups after lung resection, with the pneumonectomy group exhibiting a further decrease in longitudinal strain in LV and RV when compared with the lobectomy group (P < 0.05).Right and left ventricular dysfunction can occur after lung resection regardless of pneumonectomy or lobectomy, and lobectomy may have a less significant impact on myocardial functions. This study demonstrated that STE is able to detect acute cardiac dysfunction after lung resection.

No MeSH data available.


Related in: MedlinePlus