Evidence map›Paper›PMID 39736642›Full record

Observational studyJournal of cardiothoracic surgery2024

Potential of right ventricular function assessment with echocardiography in transcatheter aortic valve replacement.

Yoshihisa Morita, Taro Kariya, Michael Dougherty, Andrew Peters, Nicholas Ruggiero

Abstract readObservational Study
In one paragraph

Observational study in Journal of cardiothoracic surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Yoshihisa MoritaDepartment of Anesthesiology, Thomas Jefferson University, 111 South 11th St Gibbon Building, Suite 8280, Philadelphia, PA, 19107, USA. Yoshihisa.morita@jefferson.edu.
Taro KariyaDepartment of Anesthesiology, University of Tokyo, Tokyo, 113-8654, Japan.
Michael DoughertyDepartment of Anesthesiology, University of Tokyo, Tokyo, 113-8654, Japan.
Andrew PetersDepartment of Cardiology, Thomas Jefferson University, Philadelphia, PA, 19107, USA.
Nicholas RuggieroDepartment of Cardiology, Thomas Jefferson University, Philadelphia, PA, 19107, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRight ventricular (RV) function assessment by echocardiography can be challenging due to its complex morphology. Also, increasing use of sedation rather than general anesthesia for transfemoral approach transcatheter aortic valve replacement (TAVR) reduces the need for intraoperative transesophageal echocardiography (TEE). Recent clinical studies have demonstrated the importance of 3-dimensional (3D) echocardiography and a longitudinal strain for RV function assessment. In this study, we compared RV function echocardiographic assessment methodologies in TAVR and investigated its clinical utility.

methodsThis was a prospective, observational study of TAVR at a large academic hospital. Inclusion criteria were adult patients undergoing TAVR requiring intraoperative TEE between April 2023 and October 2023. Exclusion criteria include an absolute contraindication to TEE, a pacemaker, or suboptimal intraoperative echocardiography images. The primary goal is to assess the correlation of 3D RV ejection fraction (EF) with RV fraction area change (FAC), and tricuspid annular plane systolic excursion (TAPSE). The secondary goal is to assess the correlation of RV free wall longitudinal strain (FWLS) with any newly diagnosed postoperative ventricular arrhythmia, including complete atrioventricular block (CAVB) and left bundle branch block (LBBB).

resultsAmong 33 patients who underwent TAVR, 4 patients were excluded due to poor image quality, and 7 patients were excluded due to existing pacemaker. Thus, data for 22 patients were analyzed in this study. There was a good correlation between 3D RVEF and RV FAC (correlation coefficient 0.789. p = 0.0000482), but poor correlation between 3D RVEF and TAPSE (correlation coefficient 0.182. p = 0.444). Eight patients developed a new left or right BBB and CAVB postoperatively, and 3 patients required permanent pacemaker. Regression analysis of pre and post valve deployment showed RV free wall RVFWLS was each correlated with postoperative new BBB or CAVB (pre valve deployment: hazard ratio 1.272, 95% CI 1.075 to 1.505, p = 0.004981; post valve deployment: hazard ratio 1.134, 95% CI 1.001 to 1.286, p = 0.04846). No mortality was reported during the follow-up period, and no significant tricuspid regurgitation (more than moderate) was reported.

conclusion3D RVEF and RV FAC showed a good correlation. Intraoperative RVFWLS has the potential to predict postoperative new occurrence of BBB or CAVB.

Indexed as

Echocardiography, Three-DimensionalTranscatheter Aortic Valve ReplacementVentricular Function, RightAgedAged, 80 and overAortic Valve StenosisEchocardiography, TransesophagealFemaleHeart VentriclesHumansMaleProspective StudiesAtrioventricular blockRight ventricular functionSpeckle track echocardiographyTranscatheter aortic valve replacement

Identifiers

PMID39736642
PMCPMC11684122

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.