TY - JOUR
T1 - Right Ventricular Systolic Performance Determined by 2D Speckle-Tracking Echocardiography and Acute Kidney Injury After Cardiac Surgery
AU - Yockelson, Shaun R.
AU - Heitner, Stephen B.
AU - Click, Sarah
AU - Geleto, Gemechu
AU - Treggiari, Miriam M.
AU - Hutchens, Michael P.
N1 - Publisher Copyright:
© 2018 Elsevier Inc.
PY - 2019/3
Y1 - 2019/3
N2 - Objective: An association between central venous pressure and acute kidney injury (AKI) has been observed following cardiac surgery, but it is unknown whether this reflects intravascular volume status or impaired right ventricular (RV) myocardial performance. This study was performed to test the hypothesis that decreased RV peak longitudinal strain (PLSS), as measured by 2-dimensional speckle-tracking echocardiography, is associated with AKI following cardiac surgery. Design: Retrospective observational cohort study. Setting: Cardiovascular intensive care unit in a 576-bed referral hospital. Participants: Adult patients having undergone cardiac surgery in whom a transthoracic echocardiogram (TTE) was performed within 48 hours after chest closure. Interventions: This was a retrospective study. Urine output and serum creatinine values were recorded at baseline and for 48 hours after surgery. Statistical analysis was performed to identify differences in baseline demographic and echo-derived values between patients with and without postoperative AKI criteria. Measurements and Main Results: One hundred ninety-nine subjects had postprocessing of TTE performed. AKI was observed in 87% of patients (173 of 199). Age, body mass index, and preoperative serum creatinine were higher in the AKI group. The mean PLSS was -17.2% ± 4.3% versus -17.1% ± 3.7% in patients with AKI versus those without (p = 0.95). The calculated RV systolic pressure was elevated in the AKI group compared to the non-AKI group (38.9 ± 9.9 v 34.6 ± 7.9 mmHg, p = 0.02). Conclusion: In this cohort of cardiac surgery patients, speckle-tracking analysis of RV myocardial performance was feasible. Elevated RV systolic pressure associated with AKI, while speckle tracking-derived echocardiography measurements did not.
AB - Objective: An association between central venous pressure and acute kidney injury (AKI) has been observed following cardiac surgery, but it is unknown whether this reflects intravascular volume status or impaired right ventricular (RV) myocardial performance. This study was performed to test the hypothesis that decreased RV peak longitudinal strain (PLSS), as measured by 2-dimensional speckle-tracking echocardiography, is associated with AKI following cardiac surgery. Design: Retrospective observational cohort study. Setting: Cardiovascular intensive care unit in a 576-bed referral hospital. Participants: Adult patients having undergone cardiac surgery in whom a transthoracic echocardiogram (TTE) was performed within 48 hours after chest closure. Interventions: This was a retrospective study. Urine output and serum creatinine values were recorded at baseline and for 48 hours after surgery. Statistical analysis was performed to identify differences in baseline demographic and echo-derived values between patients with and without postoperative AKI criteria. Measurements and Main Results: One hundred ninety-nine subjects had postprocessing of TTE performed. AKI was observed in 87% of patients (173 of 199). Age, body mass index, and preoperative serum creatinine were higher in the AKI group. The mean PLSS was -17.2% ± 4.3% versus -17.1% ± 3.7% in patients with AKI versus those without (p = 0.95). The calculated RV systolic pressure was elevated in the AKI group compared to the non-AKI group (38.9 ± 9.9 v 34.6 ± 7.9 mmHg, p = 0.02). Conclusion: In this cohort of cardiac surgery patients, speckle-tracking analysis of RV myocardial performance was feasible. Elevated RV systolic pressure associated with AKI, while speckle tracking-derived echocardiography measurements did not.
KW - acute kidney injury
KW - cardiac surgical procedures
KW - cardiorenal syndrome
KW - echocardiography
KW - postoperative care
KW - ventricular function
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U2 - 10.1053/j.jvca.2018.09.012
DO - 10.1053/j.jvca.2018.09.012
M3 - Article
C2 - 30316640
AN - SCOPUS:85054745500
SN - 1053-0770
VL - 33
SP - 725
EP - 731
JO - Journal of cardiothoracic and vascular anesthesia
JF - Journal of cardiothoracic and vascular anesthesia
IS - 3
ER -