Katharina Seuthe, Benjamin Schuldes, Parwis Rahmanian, Henrik Ten Freyhaus, Bernd W Böttiger, Wolfgang A Wetsch, Michael Vandenheuvel, Eckhard Mauermann, Jakob Labus
{"title":"左室辅助装置植入围术期无创右心室心肌功的评价。","authors":"Katharina Seuthe, Benjamin Schuldes, Parwis Rahmanian, Henrik Ten Freyhaus, Bernd W Böttiger, Wolfgang A Wetsch, Michael Vandenheuvel, Eckhard Mauermann, Jakob Labus","doi":"10.1177/10892532251343169","DOIUrl":null,"url":null,"abstract":"<p><p><b>Background:</b> The novel method of non-invasive right ventricular (RV) myocardial work (MW) analysis provides a load-independent assessment of RV function by combining myocardial strain with loading conditions. However, its use has not been well described in the perioperative setting to date. We aimed to evaluate the feasibility of assessing RV MW, and to describe the perioperative course of this new technique. <b>Methods:</b> In this retrospective study, patients scheduled for LVAD surgery were evaluated for feasibility of RV MW analysis. Preoperative (T1) and postoperative (T2) transthoracic echocardiography (TTE) included the assessment of conventional echocardiographic measurements, myocardial strain, global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE) for the evaluation of RV function. <b>Results:</b> Ten patients had complete TTE data available for RV MW analysis, which indicated significant reduction of effective and ineffective RV MW (GWI, 212 mmHg% (IQR 128; 266) v 96 mmHg% (IQR 63; 150), <i>P</i> = 0.02; GCW, 331 mmHg% (IQR 263; 476) v 198 mmHg% (IQR 136; 274), <i>P</i> < 0.01; GWW, 171 mmHg% (IQR 102; 243) v 98 mmHg% (IQR 48; 153), <i>P</i> = 0.04), while GWE remained stable (69% (IQR 37; 78) v 64% (IQR 61; 78), <i>P</i> = 0.26) after LVAD implantation. Conventional parameters were not able to detect these changes. Moreover, there were different trends of RV MW indices in patients with and without postimplant RV failure. <b>Conclusion:</b> This study demonstrates that non-invasive RV MW assessment is feasible in the perioperative setting of LVAD implantation and provides valuable insights into RV function that are not captured by conventional echocardiographic methods. Further research is warranted to validate these findings.</p>","PeriodicalId":46500,"journal":{"name":"Seminars in Cardiothoracic and Vascular Anesthesia","volume":" ","pages":"10892532251343169"},"PeriodicalIF":1.1000,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Evaluation of Perioperative Non-Invasive Right Ventricular Myocardial Work in Left Ventricular Assist Device Implantation.\",\"authors\":\"Katharina Seuthe, Benjamin Schuldes, Parwis Rahmanian, Henrik Ten Freyhaus, Bernd W Böttiger, Wolfgang A Wetsch, Michael Vandenheuvel, Eckhard Mauermann, Jakob Labus\",\"doi\":\"10.1177/10892532251343169\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b>Background:</b> The novel method of non-invasive right ventricular (RV) myocardial work (MW) analysis provides a load-independent assessment of RV function by combining myocardial strain with loading conditions. However, its use has not been well described in the perioperative setting to date. We aimed to evaluate the feasibility of assessing RV MW, and to describe the perioperative course of this new technique. <b>Methods:</b> In this retrospective study, patients scheduled for LVAD surgery were evaluated for feasibility of RV MW analysis. Preoperative (T1) and postoperative (T2) transthoracic echocardiography (TTE) included the assessment of conventional echocardiographic measurements, myocardial strain, global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE) for the evaluation of RV function. <b>Results:</b> Ten patients had complete TTE data available for RV MW analysis, which indicated significant reduction of effective and ineffective RV MW (GWI, 212 mmHg% (IQR 128; 266) v 96 mmHg% (IQR 63; 150), <i>P</i> = 0.02; GCW, 331 mmHg% (IQR 263; 476) v 198 mmHg% (IQR 136; 274), <i>P</i> < 0.01; GWW, 171 mmHg% (IQR 102; 243) v 98 mmHg% (IQR 48; 153), <i>P</i> = 0.04), while GWE remained stable (69% (IQR 37; 78) v 64% (IQR 61; 78), <i>P</i> = 0.26) after LVAD implantation. Conventional parameters were not able to detect these changes. Moreover, there were different trends of RV MW indices in patients with and without postimplant RV failure. <b>Conclusion:</b> This study demonstrates that non-invasive RV MW assessment is feasible in the perioperative setting of LVAD implantation and provides valuable insights into RV function that are not captured by conventional echocardiographic methods. 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引用次数: 0
摘要
背景:无创右心室(RV)心肌功(MW)分析的新方法通过结合心肌应变和负荷条件,提供了一种独立于负荷的右心室功能评估方法。然而,到目前为止,它在围手术期的应用还没有很好的描述。我们的目的是评估评估RV MW的可行性,并描述这项新技术的围手术期过程。方法:在这项回顾性研究中,对计划进行LVAD手术的患者进行RV MW分析的可行性评估。术前(T1)和术后(T2)经胸超声心动图(TTE)包括评估常规超声心动图测量、心肌应变、整体功指数(GWI)、整体建设性功(GCW)、整体浪费功(GWW)和整体工作效率(GWE),以评估右心室功能。结果:10例患者有完整的TTE数据可用于RV MW分析,表明有效和无效RV MW (GWI, 212 mmHg% (IQR 128;266) v 96 mmHg% (IQR 63;150), p = 0.02;GCW, 331mmhg % (IQR 263;476) v 198 mmHg% (IQR 136;274), p < 0.01;GWW, 171 mmHg% (IQR 102;243) v 98 mmHg% (IQR 48;153), P = 0.04),而GWE保持稳定(69% (IQR 37;78) v 64% (IQR 61;78), P = 0.26)。常规参数无法检测到这些变化。此外,移植后右心室功能衰竭患者和非移植后右心室功能衰竭患者右心室MW指数的变化趋势也不同。结论:本研究表明,无创左室MW评估在LVAD植入围术期是可行的,并为传统超声心动图方法无法捕获的左室功能提供了有价值的见解。需要进一步的研究来证实这些发现。
Evaluation of Perioperative Non-Invasive Right Ventricular Myocardial Work in Left Ventricular Assist Device Implantation.
Background: The novel method of non-invasive right ventricular (RV) myocardial work (MW) analysis provides a load-independent assessment of RV function by combining myocardial strain with loading conditions. However, its use has not been well described in the perioperative setting to date. We aimed to evaluate the feasibility of assessing RV MW, and to describe the perioperative course of this new technique. Methods: In this retrospective study, patients scheduled for LVAD surgery were evaluated for feasibility of RV MW analysis. Preoperative (T1) and postoperative (T2) transthoracic echocardiography (TTE) included the assessment of conventional echocardiographic measurements, myocardial strain, global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE) for the evaluation of RV function. Results: Ten patients had complete TTE data available for RV MW analysis, which indicated significant reduction of effective and ineffective RV MW (GWI, 212 mmHg% (IQR 128; 266) v 96 mmHg% (IQR 63; 150), P = 0.02; GCW, 331 mmHg% (IQR 263; 476) v 198 mmHg% (IQR 136; 274), P < 0.01; GWW, 171 mmHg% (IQR 102; 243) v 98 mmHg% (IQR 48; 153), P = 0.04), while GWE remained stable (69% (IQR 37; 78) v 64% (IQR 61; 78), P = 0.26) after LVAD implantation. Conventional parameters were not able to detect these changes. Moreover, there were different trends of RV MW indices in patients with and without postimplant RV failure. Conclusion: This study demonstrates that non-invasive RV MW assessment is feasible in the perioperative setting of LVAD implantation and provides valuable insights into RV function that are not captured by conventional echocardiographic methods. Further research is warranted to validate these findings.