Validating Transesophageal Echocardiographic Measurements of Right Ventricular Function
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Ventricular Function, Right
- Sponsor
- Milton S. Hershey Medical Center
- Enrollment
- 126
- Locations
- 1
- Primary Endpoint
- Tricuspid annular plane systolic excursion (TAPSE)
- Status
- Completed
- Last Updated
- 6 years ago
Overview
Brief Summary
Transesophageal echocardiography (TEE) is becoming a more prevalent method of monitoring and diagnosis in the perioperative setting for critically ill patients and patients undergoing cardiac surgery. Many TEE measurements are extrapolated from transthoracic echocardiography (TTE) data and have not validated by transesophageal means. The aim of this study is to validate TEE assessment of right ventricular function by comparing them to simultaneously measured TTE measurements.
Likewise, there are currently no agreed upon values for RV free wall strain. Therefore, the investigators will attempt to define a range of normal values of RV free wall strain as compared to the other measures of RV function.
Detailed Description
Traditionally, all echocardiographic measurements have been studied utilizing TTE. Therefore the normal values and ranges for pathology findings have been defined by transthoracic means alone. TEE offers different images planes when compared to TTE, which may make the measurements obtained differ from those obtained by TTE. In the operating room environment the vast majority of echocardiography is completed by transesophageal means for many reasons; largely access to the patient and the continuous use of TEE as a hemodynamic monitor. However, given the fact that most echocardiographic measurements have only been validated by TTE, there remains a question as to the validity or precision of TEE-derived measurements.
Investigators
Shayne Michael Roberts
Assistant Professor
Milton S. Hershey Medical Center
Eligibility Criteria
Inclusion Criteria
- •Adult patients undergoing elective cardiac surgery requiring TEE
Exclusion Criteria
- •Patient who do not wish to consent
- •Patients with contraindications to TEE
- •Urgent or emergent cardiac surgery
- •Patients with preexisting open chest
- •Patients with intrathoracic hardware (VAD, thoracostomy tube, etc)
- •Non-English speaking subjects
- •Cognitively impaired adults
- •Pregnancy
Outcomes
Primary Outcomes
Tricuspid annular plane systolic excursion (TAPSE)
Time Frame: Immediately following the induction of anesthesia and TEE probe placement
Tricuspid annular plane systolic excursion (TAPSE) will be measured using both TTE and TEE.
Right ventricular fractional area change (FAC)
Time Frame: Immediately following the induction of anesthesia and TEE probe placement
Right ventricular fractional area change (FAC) will be measured using both TTE and TEE.
RV free wall longitudinal strain
Time Frame: Immediately following the induction of anesthesia and TEE probe placement
RV free wall longitudinal strain will be measured using both TTE and TEE.
Right ventricular index of myocardial performance (RIMP)
Time Frame: Immediately following the induction of anesthesia and TEE probe placement
Right ventricular index of myocardial performance (RIMP) will be measured using both TTE and TEE.
RV annular systolic velocity (S')
Time Frame: Immediately following the induction of anesthesia and TEE probe placement
RV annular systolic velocity (S') will be measured using both TTE and TEE.
Secondary Outcomes
- Ease of obtaining appropriate TEE measures of right ventricular function(Within 15 minutes following anesthesia induction)
- Define values for normal right ventricular free wall strain(Through study completion, an estimate of 1 year)