Changes in Right Ventricular Shape and Deformation Following Coronary Artery Bypass Surgery-Insights from Echocardiography with Strain Rate and Magnetic Resonance Imaging
Background This study was designed to assess whether altered RV geometry and deformation parameters persisted well into the recovery period after presumably uncomplicated coronary artery bypass grafting (CABG). It was our hypothesis that the altered geometry of and load in the RV following pericardi...
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| Veröffentlicht in: | Echocardiography (Mount Kisco, N.Y.) N.Y.), 2015-12, Vol.32 (12), p.1809-1820 |
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| creator | Rösner, Assami Avenarius, Derk Malm, Siri Iqbal, Amjid Schirmer, Henrik Bijnens, Bart Myrmel, Truls |
| description | Background
This study was designed to assess whether altered RV geometry and deformation parameters persisted well into the recovery period after presumably uncomplicated coronary artery bypass grafting (CABG). It was our hypothesis that the altered geometry of and load in the RV following pericardial opening would change both regional and global deformation indices for an extensive period postoperatively.
Methods and Results
Fifty‐seven patients scheduled for CABG underwent preoperative and 8–10 months postoperative magnetic resonance imaging (MRI) for RV volume measurements, and resting echocardiography with assessment of geometry and RV mechanical function determined by tissue Doppler imaging (TDI) based longitudinal strain. Both MRI and echocardiography revealed postoperative dilatation of the RV apex, shortened longitudinal RV length but unchanged RV ejection fraction. Echocardiography parameters associated with filling of the right atrium showed signs of constraint with a reduced systolic filling fraction and increased right atrial size. Right ventricular segmental strain (−20 ± 13% vs. −29 ± 20% preoperatively; mean ±SD, P |
| doi_str_mv | 10.1111/echo.12973 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1760927438</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1760927438</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4373-3c9862d7ab4c407cf2ad339080a1801b2630042ba5b01521d9a2b26fb86ead103</originalsourceid><addsrcrecordid>eNp9kctu1DAUhiMEokNhwwMgLxFSii-ZOFm2mel0pEKlDheJjXXiOIkhsVM70TCvxFPW07Rd4s2Rre98xzp_FL0n-IyE81nJ1p4RmnP2IlqQZYLjjPDly2iBeUJjmlF6Er3x_jfGmBOSvI5OaIoJZhQvon9FC6ZRHmmDbnXTjuiHMqPTcurAoV0Lg0JgKrRStXU9jNoadGm7zu61aVBhnTXgDujcjSqUi8MA3qPd5JpwjbfGH5Ue1c72aB2-KcFV2jYOhvaA9nps0W50cJwN4zzoCzRGjVqiW-WD20iFtj00Ydrb6FUNnVfvHutp9P1y_a24iq9vNtvi_DqWCeMsZjLPUlpxKBOZYC5rChVjOc4wkAyTkqYM44SWsCwxWVJS5UDDY11mqYIqrOU0-jh7B2fvJuVH0WsvVdeBUXbygvAU55QnLAvopxmVznrvVC0Gp_uwEEGwOGYjjtmIh2wC_OHRO5W9qp7RpzACQGZgrzt1-I9KrIurmydpPPdoP6q_zz3g_oiUM74UP79uRPZrtWMX-Ups2D3hi6sY</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1760927438</pqid></control><display><type>article</type><title>Changes in Right Ventricular Shape and Deformation Following Coronary Artery Bypass Surgery-Insights from Echocardiography with Strain Rate and Magnetic Resonance Imaging</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Rösner, Assami ; Avenarius, Derk ; Malm, Siri ; Iqbal, Amjid ; Schirmer, Henrik ; Bijnens, Bart ; Myrmel, Truls</creator><creatorcontrib>Rösner, Assami ; Avenarius, Derk ; Malm, Siri ; Iqbal, Amjid ; Schirmer, Henrik ; Bijnens, Bart ; Myrmel, Truls</creatorcontrib><description>Background
This study was designed to assess whether altered RV geometry and deformation parameters persisted well into the recovery period after presumably uncomplicated coronary artery bypass grafting (CABG). It was our hypothesis that the altered geometry of and load in the RV following pericardial opening would change both regional and global deformation indices for an extensive period postoperatively.
Methods and Results
Fifty‐seven patients scheduled for CABG underwent preoperative and 8–10 months postoperative magnetic resonance imaging (MRI) for RV volume measurements, and resting echocardiography with assessment of geometry and RV mechanical function determined by tissue Doppler imaging (TDI) based longitudinal strain. Both MRI and echocardiography revealed postoperative dilatation of the RV apex, shortened longitudinal RV length but unchanged RV ejection fraction. Echocardiography parameters associated with filling of the right atrium showed signs of constraint with a reduced systolic filling fraction and increased right atrial size. Right ventricular segmental strain (−20 ± 13% vs. −29 ± 20% preoperatively; mean ±SD, P < 0.0001) was reduced postoperatively in parallel with TAPSE (1.3 ± 0.3 cm vs. 2.2 ± 0.4 cm; P < 0.0001).
Conclusion
Post‐CABG longitudinal motion of the RV lateral wall is reduced after uneventful CABG despite preserved RV ejection fraction and stroke volume. The discrepancy in various RV systolic performance indicators results from increased sphericity of the RV following opening the pericardium during surgery. Therefore, longitudinal functional parameters may underestimate RV systolic function for at least 8–10 months post‐CABG. Changes in deformation parameters should thus always be interpreted in relation to changes in geometry.</description><identifier>ISSN: 0742-2822</identifier><identifier>EISSN: 1540-8175</identifier><identifier>DOI: 10.1111/echo.12973</identifier><identifier>PMID: 26010320</identifier><language>eng</language><publisher>United States: Blackwell Publishing Ltd</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Coronary Artery Bypass - adverse effects ; coronary artery bypass graft surgery ; Echocardiography - methods ; Elastic Modulus ; Elasticity Imaging Techniques - methods ; Female ; Heart Ventricles - diagnostic imaging ; Heart Ventricles - pathology ; Heart Ventricles - physiopathology ; Humans ; Image Interpretation, Computer-Assisted - methods ; Magnetic Resonance Imaging - methods ; Male ; Middle Aged ; Multimodal Imaging - methods ; Observer Variation ; Organ Size ; pericardial opening ; Reproducibility of Results ; right ventricle ; Sensitivity and Specificity ; strain ; Stress, Mechanical ; Ventricular Dysfunction, Right - diagnosis ; Ventricular Dysfunction, Right - etiology ; Ventricular Dysfunction, Right - physiopathology</subject><ispartof>Echocardiography (Mount Kisco, N.Y.), 2015-12, Vol.32 (12), p.1809-1820</ispartof><rights>2015, Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4373-3c9862d7ab4c407cf2ad339080a1801b2630042ba5b01521d9a2b26fb86ead103</citedby><cites>FETCH-LOGICAL-c4373-3c9862d7ab4c407cf2ad339080a1801b2630042ba5b01521d9a2b26fb86ead103</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fecho.12973$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fecho.12973$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,778,782,1414,27907,27908,45557,45558</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26010320$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rösner, Assami</creatorcontrib><creatorcontrib>Avenarius, Derk</creatorcontrib><creatorcontrib>Malm, Siri</creatorcontrib><creatorcontrib>Iqbal, Amjid</creatorcontrib><creatorcontrib>Schirmer, Henrik</creatorcontrib><creatorcontrib>Bijnens, Bart</creatorcontrib><creatorcontrib>Myrmel, Truls</creatorcontrib><title>Changes in Right Ventricular Shape and Deformation Following Coronary Artery Bypass Surgery-Insights from Echocardiography with Strain Rate and Magnetic Resonance Imaging</title><title>Echocardiography (Mount Kisco, N.Y.)</title><addtitle>Echocardiography</addtitle><description>Background
This study was designed to assess whether altered RV geometry and deformation parameters persisted well into the recovery period after presumably uncomplicated coronary artery bypass grafting (CABG). It was our hypothesis that the altered geometry of and load in the RV following pericardial opening would change both regional and global deformation indices for an extensive period postoperatively.
Methods and Results
Fifty‐seven patients scheduled for CABG underwent preoperative and 8–10 months postoperative magnetic resonance imaging (MRI) for RV volume measurements, and resting echocardiography with assessment of geometry and RV mechanical function determined by tissue Doppler imaging (TDI) based longitudinal strain. Both MRI and echocardiography revealed postoperative dilatation of the RV apex, shortened longitudinal RV length but unchanged RV ejection fraction. Echocardiography parameters associated with filling of the right atrium showed signs of constraint with a reduced systolic filling fraction and increased right atrial size. Right ventricular segmental strain (−20 ± 13% vs. −29 ± 20% preoperatively; mean ±SD, P < 0.0001) was reduced postoperatively in parallel with TAPSE (1.3 ± 0.3 cm vs. 2.2 ± 0.4 cm; P < 0.0001).
Conclusion
Post‐CABG longitudinal motion of the RV lateral wall is reduced after uneventful CABG despite preserved RV ejection fraction and stroke volume. The discrepancy in various RV systolic performance indicators results from increased sphericity of the RV following opening the pericardium during surgery. Therefore, longitudinal functional parameters may underestimate RV systolic function for at least 8–10 months post‐CABG. Changes in deformation parameters should thus always be interpreted in relation to changes in geometry.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Coronary Artery Bypass - adverse effects</subject><subject>coronary artery bypass graft surgery</subject><subject>Echocardiography - methods</subject><subject>Elastic Modulus</subject><subject>Elasticity Imaging Techniques - methods</subject><subject>Female</subject><subject>Heart Ventricles - diagnostic imaging</subject><subject>Heart Ventricles - pathology</subject><subject>Heart Ventricles - physiopathology</subject><subject>Humans</subject><subject>Image Interpretation, Computer-Assisted - methods</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multimodal Imaging - methods</subject><subject>Observer Variation</subject><subject>Organ Size</subject><subject>pericardial opening</subject><subject>Reproducibility of Results</subject><subject>right ventricle</subject><subject>Sensitivity and Specificity</subject><subject>strain</subject><subject>Stress, Mechanical</subject><subject>Ventricular Dysfunction, Right - diagnosis</subject><subject>Ventricular Dysfunction, Right - etiology</subject><subject>Ventricular Dysfunction, Right - physiopathology</subject><issn>0742-2822</issn><issn>1540-8175</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kctu1DAUhiMEokNhwwMgLxFSii-ZOFm2mel0pEKlDheJjXXiOIkhsVM70TCvxFPW07Rd4s2Rre98xzp_FL0n-IyE81nJ1p4RmnP2IlqQZYLjjPDly2iBeUJjmlF6Er3x_jfGmBOSvI5OaIoJZhQvon9FC6ZRHmmDbnXTjuiHMqPTcurAoV0Lg0JgKrRStXU9jNoadGm7zu61aVBhnTXgDujcjSqUi8MA3qPd5JpwjbfGH5Ue1c72aB2-KcFV2jYOhvaA9nps0W50cJwN4zzoCzRGjVqiW-WD20iFtj00Ydrb6FUNnVfvHutp9P1y_a24iq9vNtvi_DqWCeMsZjLPUlpxKBOZYC5rChVjOc4wkAyTkqYM44SWsCwxWVJS5UDDY11mqYIqrOU0-jh7B2fvJuVH0WsvVdeBUXbygvAU55QnLAvopxmVznrvVC0Gp_uwEEGwOGYjjtmIh2wC_OHRO5W9qp7RpzACQGZgrzt1-I9KrIurmydpPPdoP6q_zz3g_oiUM74UP79uRPZrtWMX-Ups2D3hi6sY</recordid><startdate>201512</startdate><enddate>201512</enddate><creator>Rösner, Assami</creator><creator>Avenarius, Derk</creator><creator>Malm, Siri</creator><creator>Iqbal, Amjid</creator><creator>Schirmer, Henrik</creator><creator>Bijnens, Bart</creator><creator>Myrmel, Truls</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201512</creationdate><title>Changes in Right Ventricular Shape and Deformation Following Coronary Artery Bypass Surgery-Insights from Echocardiography with Strain Rate and Magnetic Resonance Imaging</title><author>Rösner, Assami ; Avenarius, Derk ; Malm, Siri ; Iqbal, Amjid ; Schirmer, Henrik ; Bijnens, Bart ; Myrmel, Truls</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4373-3c9862d7ab4c407cf2ad339080a1801b2630042ba5b01521d9a2b26fb86ead103</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Coronary Artery Bypass - adverse effects</topic><topic>coronary artery bypass graft surgery</topic><topic>Echocardiography - methods</topic><topic>Elastic Modulus</topic><topic>Elasticity Imaging Techniques - methods</topic><topic>Female</topic><topic>Heart Ventricles - diagnostic imaging</topic><topic>Heart Ventricles - pathology</topic><topic>Heart Ventricles - physiopathology</topic><topic>Humans</topic><topic>Image Interpretation, Computer-Assisted - methods</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multimodal Imaging - methods</topic><topic>Observer Variation</topic><topic>Organ Size</topic><topic>pericardial opening</topic><topic>Reproducibility of Results</topic><topic>right ventricle</topic><topic>Sensitivity and Specificity</topic><topic>strain</topic><topic>Stress, Mechanical</topic><topic>Ventricular Dysfunction, Right - diagnosis</topic><topic>Ventricular Dysfunction, Right - etiology</topic><topic>Ventricular Dysfunction, Right - physiopathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rösner, Assami</creatorcontrib><creatorcontrib>Avenarius, Derk</creatorcontrib><creatorcontrib>Malm, Siri</creatorcontrib><creatorcontrib>Iqbal, Amjid</creatorcontrib><creatorcontrib>Schirmer, Henrik</creatorcontrib><creatorcontrib>Bijnens, Bart</creatorcontrib><creatorcontrib>Myrmel, Truls</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Echocardiography (Mount Kisco, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rösner, Assami</au><au>Avenarius, Derk</au><au>Malm, Siri</au><au>Iqbal, Amjid</au><au>Schirmer, Henrik</au><au>Bijnens, Bart</au><au>Myrmel, Truls</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Changes in Right Ventricular Shape and Deformation Following Coronary Artery Bypass Surgery-Insights from Echocardiography with Strain Rate and Magnetic Resonance Imaging</atitle><jtitle>Echocardiography (Mount Kisco, N.Y.)</jtitle><addtitle>Echocardiography</addtitle><date>2015-12</date><risdate>2015</risdate><volume>32</volume><issue>12</issue><spage>1809</spage><epage>1820</epage><pages>1809-1820</pages><issn>0742-2822</issn><eissn>1540-8175</eissn><abstract>Background
This study was designed to assess whether altered RV geometry and deformation parameters persisted well into the recovery period after presumably uncomplicated coronary artery bypass grafting (CABG). It was our hypothesis that the altered geometry of and load in the RV following pericardial opening would change both regional and global deformation indices for an extensive period postoperatively.
Methods and Results
Fifty‐seven patients scheduled for CABG underwent preoperative and 8–10 months postoperative magnetic resonance imaging (MRI) for RV volume measurements, and resting echocardiography with assessment of geometry and RV mechanical function determined by tissue Doppler imaging (TDI) based longitudinal strain. Both MRI and echocardiography revealed postoperative dilatation of the RV apex, shortened longitudinal RV length but unchanged RV ejection fraction. Echocardiography parameters associated with filling of the right atrium showed signs of constraint with a reduced systolic filling fraction and increased right atrial size. Right ventricular segmental strain (−20 ± 13% vs. −29 ± 20% preoperatively; mean ±SD, P < 0.0001) was reduced postoperatively in parallel with TAPSE (1.3 ± 0.3 cm vs. 2.2 ± 0.4 cm; P < 0.0001).
Conclusion
Post‐CABG longitudinal motion of the RV lateral wall is reduced after uneventful CABG despite preserved RV ejection fraction and stroke volume. The discrepancy in various RV systolic performance indicators results from increased sphericity of the RV following opening the pericardium during surgery. Therefore, longitudinal functional parameters may underestimate RV systolic function for at least 8–10 months post‐CABG. Changes in deformation parameters should thus always be interpreted in relation to changes in geometry.</abstract><cop>United States</cop><pub>Blackwell Publishing Ltd</pub><pmid>26010320</pmid><doi>10.1111/echo.12973</doi><tpages>12</tpages></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Coronary Artery Bypass - adverse effects coronary artery bypass graft surgery Echocardiography - methods Elastic Modulus Elasticity Imaging Techniques - methods Female Heart Ventricles - diagnostic imaging Heart Ventricles - pathology Heart Ventricles - physiopathology Humans Image Interpretation, Computer-Assisted - methods Magnetic Resonance Imaging - methods Male Middle Aged Multimodal Imaging - methods Observer Variation Organ Size pericardial opening Reproducibility of Results right ventricle Sensitivity and Specificity strain Stress, Mechanical Ventricular Dysfunction, Right - diagnosis Ventricular Dysfunction, Right - etiology Ventricular Dysfunction, Right - physiopathology |
| title | Changes in Right Ventricular Shape and Deformation Following Coronary Artery Bypass Surgery-Insights from Echocardiography with Strain Rate and Magnetic Resonance Imaging |
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