Neeki Alavi, Wilton Van Klei, Kwame Agyei, Amir Zabida, Mosana Abraha, Marcus Salvatori, Azad Mashari, Justyna Bartoszko
{"title":"心脏手术后右心室功能与预后的关系：一项系统综述。","authors":"Neeki Alavi, Wilton Van Klei, Kwame Agyei, Amir Zabida, Mosana Abraha, Marcus Salvatori, Azad Mashari, Justyna Bartoszko","doi":"10.1007/s12630-024-02898-9","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Assessment of right ventricular (RV) function is recommended as part of a comprehensive echocardiography exam, including before and after cardiac surgery. Nevertheless, the prognostic implications of various measures of RV function in patients undergoing cardiac surgery are not well characterized. Our goal was to conduct a focused systematic review to assess the association of quantitative parameters of RV function with postoperative outcomes in patients undergoing cardiac surgery.</p><p><strong>Methods: </strong>We conducted a systematic review of randomized controlled trials or observational studies in adult (≥ 18 yr) patients undergoing cardiac surgery with a reported echocardiogram within six months of surgery, intraoperatively, or shortly after surgery. We excluded case reports and case series. Databases included PubMed® and MEDLINE, and papers published from 1 January 1990 to 22 April 2024 were searched for. The primary predictors of interest were quantitative RV function parameters. The primary outcome of interest was postoperative mortality up to five years. The secondary outcome was all major adverse cardiac events (MACE).</p><p><strong>Results: </strong>We identified 7,187 potentially relevant studies, 27 of which were included; all of these were observational studies. Right ventricular fractional area change (RVFAC) was the most commonly reported parameter, but was inconsistently associated with mortality and MACE. Tricuspid annular plane systolic excursion (TAPSE) and strain were consistently associated with mortality. The most consistent predictor of MACE was RV myocardial performance index (MPI) across studies.</p><p><strong>Conclusion: </strong>Pre- and perioperative assessment of RV function using at least two quantitative echocardiographic parameters may offer prognostic information in patients undergoing cardiac surgery. Right ventricular FAC, TAPSE, strain, and RV MPI have been frequently studied; however, further research is needed to delineate the role of echocardiographic RV quantification for perioperative prognostication.</p><p><strong>Study registration: </strong>PROSPERO ( CRD42023387383 ); first submitted 23 December 2022.</p>","PeriodicalId":56145,"journal":{"name":"Canadian Journal of Anesthesia-Journal Canadien D Anesthesie","volume":" ","pages":"285-318"},"PeriodicalIF":3.4000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The association of right ventricular function with outcomes after cardiac surgery: a systematic review.\",\"authors\":\"Neeki Alavi, Wilton Van Klei, Kwame Agyei, Amir Zabida, Mosana Abraha, Marcus Salvatori, Azad Mashari, Justyna Bartoszko\",\"doi\":\"10.1007/s12630-024-02898-9\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Assessment of right ventricular (RV) function is recommended as part of a comprehensive echocardiography exam, including before and after cardiac surgery. Nevertheless, the prognostic implications of various measures of RV function in patients undergoing cardiac surgery are not well characterized. Our goal was to conduct a focused systematic review to assess the association of quantitative parameters of RV function with postoperative outcomes in patients undergoing cardiac surgery.</p><p><strong>Methods: </strong>We conducted a systematic review of randomized controlled trials or observational studies in adult (≥ 18 yr) patients undergoing cardiac surgery with a reported echocardiogram within six months of surgery, intraoperatively, or shortly after surgery. We excluded case reports and case series. Databases included PubMed® and MEDLINE, and papers published from 1 January 1990 to 22 April 2024 were searched for. The primary predictors of interest were quantitative RV function parameters. The primary outcome of interest was postoperative mortality up to five years. The secondary outcome was all major adverse cardiac events (MACE).</p><p><strong>Results: </strong>We identified 7,187 potentially relevant studies, 27 of which were included; all of these were observational studies. Right ventricular fractional area change (RVFAC) was the most commonly reported parameter, but was inconsistently associated with mortality and MACE. Tricuspid annular plane systolic excursion (TAPSE) and strain were consistently associated with mortality. The most consistent predictor of MACE was RV myocardial performance index (MPI) across studies.</p><p><strong>Conclusion: </strong>Pre- and perioperative assessment of RV function using at least two quantitative echocardiographic parameters may offer prognostic information in patients undergoing cardiac surgery. Right ventricular FAC, TAPSE, strain, and RV MPI have been frequently studied; however, further research is needed to delineate the role of echocardiographic RV quantification for perioperative prognostication.</p><p><strong>Study registration: </strong>PROSPERO ( CRD42023387383 ); first submitted 23 December 2022.</p>\",\"PeriodicalId\":56145,\"journal\":{\"name\":\"Canadian Journal of Anesthesia-Journal Canadien D Anesthesie\",\"volume\":\" \",\"pages\":\"285-318\"},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2025-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Canadian Journal of Anesthesia-Journal Canadien D Anesthesie\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s12630-024-02898-9\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/2/12 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"ANESTHESIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Canadian Journal of Anesthesia-Journal Canadien D Anesthesie","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s12630-024-02898-9","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/2/12 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
The association of right ventricular function with outcomes after cardiac surgery: a systematic review.
Purpose: Assessment of right ventricular (RV) function is recommended as part of a comprehensive echocardiography exam, including before and after cardiac surgery. Nevertheless, the prognostic implications of various measures of RV function in patients undergoing cardiac surgery are not well characterized. Our goal was to conduct a focused systematic review to assess the association of quantitative parameters of RV function with postoperative outcomes in patients undergoing cardiac surgery.
Methods: We conducted a systematic review of randomized controlled trials or observational studies in adult (≥ 18 yr) patients undergoing cardiac surgery with a reported echocardiogram within six months of surgery, intraoperatively, or shortly after surgery. We excluded case reports and case series. Databases included PubMed® and MEDLINE, and papers published from 1 January 1990 to 22 April 2024 were searched for. The primary predictors of interest were quantitative RV function parameters. The primary outcome of interest was postoperative mortality up to five years. The secondary outcome was all major adverse cardiac events (MACE).
Results: We identified 7,187 potentially relevant studies, 27 of which were included; all of these were observational studies. Right ventricular fractional area change (RVFAC) was the most commonly reported parameter, but was inconsistently associated with mortality and MACE. Tricuspid annular plane systolic excursion (TAPSE) and strain were consistently associated with mortality. The most consistent predictor of MACE was RV myocardial performance index (MPI) across studies.
Conclusion: Pre- and perioperative assessment of RV function using at least two quantitative echocardiographic parameters may offer prognostic information in patients undergoing cardiac surgery. Right ventricular FAC, TAPSE, strain, and RV MPI have been frequently studied; however, further research is needed to delineate the role of echocardiographic RV quantification for perioperative prognostication.
Study registration: PROSPERO ( CRD42023387383 ); first submitted 23 December 2022.
期刊介绍：
The Canadian Journal of Anesthesia (the Journal) is owned by the Canadian Anesthesiologists’
Society and is published by Springer Science + Business Media, LLM (New York). From the
first year of publication in 1954, the international exposure of the Journal has broadened
considerably, with articles now received from over 50 countries. The Journal is published
monthly, and has an impact Factor (mean journal citation frequency) of 2.127 (in 2012). Article
types consist of invited editorials, reports of original investigations (clinical and basic sciences
articles), case reports/case series, review articles, systematic reviews, accredited continuing
professional development (CPD) modules, and Letters to the Editor. The editorial content,
according to the mission statement, spans the fields of anesthesia, acute and chronic pain,
perioperative medicine and critical care. In addition, the Journal publishes practice guidelines
and standards articles relevant to clinicians. Articles are published either in English or in French,
according to the language of submission.
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