Key result
In 80 patients following pulmonary endarterectomy, the RVEDA/LVEDA ratio correlated with ideal cardiac index (r=0.57), whereas RV annular indices associated poorly with postoperative cardiac index.
Why the study?
Echocardiographic RV annular parameters may be unreliable for assessing surgical success post-PEA, whereas the RVEDA/LVEDA ratio may be more useful.
Does the RVEDA/LVEDA ratio correlate better with ideal cardiac index than right ventricular annular parameters in the early postoperative period following pulmonary endarterectomy?
Observational (n=80)
Does the RVEDA/LVEDA ratio correlate better with ideal cardiac index than right ventricular annular parameters in the early postoperative period following pulmonary endarterectomy?
The RVEDA/LVEDA ratio is a more reliable echocardiographic parameter than right ventricular annular indices for evaluating right ventricular function and surgical success in the early postoperative period after pulmonary endarterectomy.
Answers are grounded in this paper and cite their sources.
RVEDA/LVEDA ratio may aid postoperative cardiac index assessment after endarterectomy; leaves open validation in prospective cohorts.
OBJECTIVES: Echocardiographic right ventricular (RV) annular parameters are probably not as reliable to evaluate the surgical success in the postoperative period after pulmonary endarterectomy (PEA), whereas RV end-diastolic/left ventricular end-diastolic area ratio (RVEDA/LVEDA ratio) could be more useful. This study examined the relationship between RV annular parameters or RVEDA/LVEDA ratio and ideal cardiac index (ICI), before and after PEA. METHODS: Among 80 patients who underwent PEA, the relationships between RVEDA/LVEDA ratio (21 patients), or tricuspid annular plane systolic excursion (32 patients), or systolic tricuspid annular velocity (55 patients) and ICI were modelled. RESULTS: Forty-eight hours following PEA, mean pulmonary artery pressure decreased (26 ± 6 vs 46 ± 12 mmHg, P < 0.0001) and ICI improved (2.8 ± 0.8 vs 3.0 ± 0.9 l/min/m2, P = 0.02). In contrast to the moderate association between RV annular indices and ICI in the preoperative period, no significant relationship was found in the postoperative period (r = 0.54 and 0.17 for tricuspid annular plane systolic excursion and r = 0.46 and 0.16 for systolic tricuspid annular velocity, respectively). The RVEDA/LVEDA ratio significantly decreased postoperatively (0.97 ± 0.21 vs 1.19 ± 0.43, P = 0.002) and was correlated with ICI both in preoperative and postoperative periods (r = 0.57 and 0.57, respectively). There was a significant correlation between changes in RVEDA/LVEDA ratio and changes in total pulmonary resistance. CONCLUSIONS: Improved ICI and RVEDA/LVEDA ratio reflected the surgical success of PEA and lowering of total pulmonary resistances. In contrast to the RV/left ventricular area ratio, annular RV indices associated poorly with postoperative ICI. Recognizing this limitation is important in minimizing the overdiagnosis of RV dysfunction after PEA.
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Rézaiguia‐Delclaux et al. (2020) conducted an observational in Pulmonary endarterectomy (PEA) (n=80). Echocardiographic right ventricular parameters was evaluated on Relationship between RVEDA/LVEDA ratio and ideal cardiac index (ICI) postoperatively (r = 0.57). In 80 patients following pulmonary endarterectomy, the RVEDA/LVEDA ratio correlated with ideal cardiac index (r=0.57), whereas RV annular indices associated poorly with postoperative cardiac index.
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