The utility of trans thoracic echocardiograhic measures of right ventricular systolic function in a lung resection cohort

Right ventricular (RV) dysfunction occurs following lung resection and is associated with post-operative complications and long-term functional morbidity. Accurate peri-operative assessment of RV function would have utility in this population. The difficulties of transthoracic echocardiographic (TTE) assessment of RV function may be compounded following lung resection surgery, and no parameters have been validated in this patient group. This study compares conventional TTE methods for assessing RV systolic function to a reference method in a lung resection population. Right ventricular index of myocardial performance (RIMP), fractional area change (FAC), tricuspid annular plane systolic excursion (TAPSE) and S′ wave velocity at the tricuspid annulus (S′), along with speckle tracked global and free wall longitudinal strain (RV-GPLS and RV-FWPLS respectively) are compared with RV ejection fraction obtained by cardiovascular magnetic resonance (RVEFCMR). Twenty-seven patients undergoing lung resection underwent contemporaneous CMR and TTE imaging; pre-operatively, on post-operative day two and at 2 months. Ability of each of the parameters to predict RV dysfunction (RVEFCMR <45%) was assessed using the area under the receiver operating characteristic curve (AUROCC). RIMP, FAC and S′ demonstrated no predictive value for poor RV function (AUROCC <0.61, P > 0.05). TAPSE performed marginally better with an AUROCC of 0.65 (P = 0.04). RV-GPLS and RV-FWPLS demonstrated good predictive ability with AUROCC’s of 0.74 and 0.76 respectively (P < 0.01 for both). This study demonstrates that the conventional TTE parameters of RV systolic function are inadequate following lung resection. Longitudinal strain performs better and offers some ability to determine poor RV function in this challenging population

Defining Heart Failure Based on Imaging the Heart and Beyond

Water and salt retention, in other words congestion, are fundamental to the pathophysiology of heart failure and are important therapeutic targets. Echocardiography is the key tool with which to assess cardiac structure and function in the initial diagnostic workup of patients with suspected heart failure and is essential for guiding treatment and stratifying risk. Ultrasound can also be used to identify and quantify congestion in the great veins, kidneys and lungs. More advanced imaging methods might further clarify the aetiology of heart failure and its consequences for the heart and periphery, thereby improving the efficiency and quality of care tailored with greater precision to individual patient need

Report from the Annual Conference of the British Society of Echocardiography, November 2017, Edinburgh International Conference Centre, Edinburgh

No abstract available

Transthoracic Doppler echocardiography for the non-invasive assessment of coronary flow reserve - a case report

Abstract: We describe a case of a 55-year-old male with anterior myocardial infarction, treated in the acute phase with thrombolysis. Transthoracic echocardiography showed hypokinetic apical segments, ejection fraction of 55% and reduced coronary flow reserve in the left anterior descending (LAD) coronary artery. Elective coronary angiography revealed a borderline (40-50%) lesion in LAD. The patient underwent successful angioplasty of LAD with stent implantation. Non-invasive coronary flow reserve measurements were repeated 3 days, 6 weeks and 6 months after angioplasty showing continuous improvement in this parameter. The role of non-invasive echocardiographic assessment of coronary flow reserve in the selection for angioplasty and monitoring of the effects of treatment is discussed

Defining Heart Failure Based on Imaging the heart and beyond

No abstract available