Echocardiographic correlates of pressure-volume-derived indices: Advancing intraoperative assessment of right ventricular function

Figures

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  Intraoperative RV-PA coupling assessment using PAC waveforms and 3D TEE-derived volumes.

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  Figure 1. A, Intraoperative right ventricular (RV) pressure waveform monitoring and measurement. The white arrow denotes the end-diastolic pressure (EDP). B, RV volume assessment using GE Healthcare's 4D auto RVQ tool.

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  Figure 2. Flowchart illustrating patient screening, exclusions, and final cohort formation. CPB, Cardiopulmonary bypass; TEE, transesophageal echocardiography.

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  Figure 3. Receiver operating characteristic (ROC) curves demonstrating the discriminative performance of (A) 3D ejection fraction (EF), (B) 4D-derived fractional area change (FAC), and (C) indexed end-systolic volume (ESVi) for identifying patients with impaired right ventricle-pulmonary artery coupling (Ees/Ea <0.8). Optimal cutoff values were derived using Youden's J statistic.

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  Figure 4. Restricted cubic spline models demonstrating the nonlinear association between RV-PA coupling (Ees/Ea) and (A) 3-dimensional ejection fraction (EF), (B) 4-dimensional–derived fractional area change (FAC), and (C) indexed 3-dimensional end-systolic volume (ESVi). The red line indicates the fitted spline relationship, and the blue shaded region represents the 95% CI. RV-PA, Right ventricle-pulmonary artery.

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  Figure E1. Exploratory ROC curves evaluating the ability of Ees/Ea and echocardiographic surrogates to predict prolonged postoperative vasopressor or inotrope use. ROC, Receiver under the operating characteristic; Ees, end-systolic elastance; Ea, effective arterial elastance; FAC, fractional area change; RVSP, right ventricular systolic pressure; AUC, area under the curve.