Preoperative right ventricular strain as an early predictor of perioperative cardiac failure in patients undergoing mitral surgery: An exploratory study.

Autor: Russo A; Cardio‑thoracic Anaesthesia and Intensive Care Unit University of Verona, AOUI‑University Hospital Integrated Trust of Verona Verona Italy., Bergamini Viola E; Cardio‑thoracic Anaesthesia and Intensive Care Unit University of Verona, AOUI‑University Hospital Integrated Trust of Verona Verona Italy., Gambaro A; Department of Medicine, Cardiology Division, University Hospital Integrated Trust of Verona University of Verona Verona Italy., Di Gennaro G; Department of Health Sciences, Medical Statistics University of Magna Graecia Catanzaro Italy., Fanti D; Department of Medicine, Cardiology Division, University Hospital Integrated Trust of Verona University of Verona Verona Italy., Devigili A; Cardio‑thoracic Anaesthesia and Intensive Care Unit University of Verona, AOUI‑University Hospital Integrated Trust of Verona Verona Italy., Ceola Graziadei M; Cardio‑thoracic Anaesthesia and Intensive Care Unit University of Verona, AOUI‑University Hospital Integrated Trust of Verona Verona Italy., Brognoli G; Cardio‑thoracic Anaesthesia and Intensive Care Unit University of Verona, AOUI‑University Hospital Integrated Trust of Verona Verona Italy., Corubolo L; Cardio‑thoracic Anaesthesia and Intensive Care Unit University of Verona, AOUI‑University Hospital Integrated Trust of Verona Verona Italy., Rama J; Cardio‑thoracic Anaesthesia and Intensive Care Unit University of Verona, AOUI‑University Hospital Integrated Trust of Verona Verona Italy., Zanin A; Cardio‑thoracic Anaesthesia and Intensive Care Unit University of Verona, AOUI‑University Hospital Integrated Trust of Verona Verona Italy., Schweiger V; Anaesthesia and Intensive Care B Unit, AOUI‑University Hospital Integrated Trust of Verona University of Verona Verona Italy., Donadello K; Anaesthesia and Intensive Care B Unit, AOUI‑University Hospital Integrated Trust of Verona University of Verona Verona Italy., Polati E; Anaesthesia and Intensive Care B Unit, AOUI‑University Hospital Integrated Trust of Verona University of Verona Verona Italy., Gottin L; Cardio‑thoracic Anaesthesia and Intensive Care Unit University of Verona, AOUI‑University Hospital Integrated Trust of Verona Verona Italy.
Jazyk: angličtina
Zdroj: Health science reports [Health Sci Rep] 2024 Jul 23; Vol. 7 (7), pp. e2172. Date of Electronic Publication: 2024 Jul 23 (Print Publication: 2024).
DOI: 10.1002/hsr2.2172
Abstrakt: Objectives: This study's primary purpose was to demonstrate the correlation of preoperative right ventricular free-wall longitudinal strain (RVFWLS) and pre-/postsurgical variation in strain (delta strain) with the clinical and echocardiographic diagnosis of right ventricular dysfunction. Its secondary purpose was to determine the correlation of RVFWLS and delta strain with length of stay (LOS) in the intensive care unit (ICU), ventilation days, trend of natriuretic peptide test. (NT-proBNP) and lactate in the first 48 h, incidence of acute renal failure, and 28-day mortality.
Design: Prospective observational study.
Setting: Cardio-thoracic and Vascular Anaesthesia Department and ICU of the University Hospital Integrated Trust of Verona.
Participants: Patients scheduled for mitral surgery.
Interventions: None.
Measurements and Main Results: All clinical and transoesophageal echocardiographic (TEE) parameters were collected at baseline, before surgery (T1) and at admission in the ICU postsurgery (T2). During the postoperative period, the clinical and echocardiographic diagnoses of right, left, or biventricular dysfunction were evaluated. TEE parameters were evaluated by a cardiologist offline. The patients were divided into two subgroups according to the development of any type of ventricular dysfunction. No statistically significant differences emerged between the two groups. According to a logistic regression model, a T1-RVFWLS value of -15% appeared to predict biventricular dysfunction (sensitivity: 100%; specificity: 91.3%). No correlation between T1- or T2-RVFWLS and creatinine, hours of ventilation or ICU LOS was found.
Conclusions: Our study introduces a new parameter that could be used in perioperative evaluations to identify patients at risk of postoperative biventricular dysfunction.
Competing Interests: The authors declare no conflict of interest.
(© 2024 The Author(s). Health Science Reports published by Wiley Periodicals LLC.)
Databáze: MEDLINE
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