Determination of right ventricular function by transesophageal echocardiography: impact of proximal right coronary artery stenosis.
OBJECTIVE
To investigate whether transesophageal echocardiography (TEE) can provide accurate information on right ventricular (RV) function in patients with right coronary artery (RCA) stenosis, given that a decrease in blood supply from the RCA may invalidate the use of single 2-D echocardiography imaging plane as a guide to RV function.


METHODS
Prospective, nonblinded study.


METHODS
University hospital.


METHODS
30 adult patients undergoing elective cardiac or vascular procedures.


METHODS
Patients were classified into two groups according to the presence or absence of the proximal RCA (segment 1 or 2) stenosis. Group A patients had no obstructive lesions in the proximal RCA (n = 15). Group B patients had 75% or greater obstructive lesions in the proximal RCA (n = 15).


RESULTS
After induction of anesthesia, RV function was evaluated by both fast-response thermodilution pulmonary artery catheter and TEE. Transesophageal echocardiography-derived RV fractional area change (FAC) and tricuspid annular plane systolic excursion ratio (TAPSE ratio) were compared with thermodilution-derived RV ejection fraction (EF) using linear regression analysis. Transesophageal echocardiography-derived RV end-diastolic area (EDA) was compared with thermodilution-derived end-diastolic volume (EDV). Both methods showed a good correlation in RV, EDV, and EF in Group A, but no correlations in Group B.


CONCLUSIONS
Transesophageal echocardiography does not provide reliable information on RVEF and EDV when proximal RCA stenosis is present.
Niimi
Yoshinari
Y
Department of Anesthesiology, Teikyo University School of Medicine, Tokyo, Japan.
Hiki
Mika
M
Ishiguro
Yoshiki
Y
Goto
Takahisa
T
Morita
Shigeho
S
D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D017548:Echocardiography, Transesophageal; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D013318:Stroke Volume; D013815:Thermodilution; D014261:Tricuspid Valve / Q000000981:diagnostic imaging; D016278:Ventricular Function, Right