Tissue Doppler evaluation of the effects of major lung resection on cardiac functions.
OBJECTIVE
The aim of our study was to evaluate the influence of lung resection on cardiac functions by using tissue Doppler echocardiography.


METHODS
Nineteen consecutive patients (15 males, 4 females; mean age 55+/-8 years) undergoing major lung surgery (16 lobectomy, 3 pneumonectomy) were evaluated in a prospective design. Malignant lung cancer (n=15, 79%) was the major cause for lung surgery. Exclusion criteria were a history of myocardial infarction, angina, atrial fibrillation, valvular heart disease, major arrhythmias, diastolic dysfunction, heart surgery, and FEV1/FVC ratio lower than 60%. Two-dimensional Doppler echocardiography and tissue Doppler imaging (TDI) were performed one or two days before surgery and 4+/-2 weeks postoperatively.


RESULTS
Compared to the preoperative measurements, right and left atrial and ventricular dimensions did not differ after surgery (p>0.05). Left ventricular ejection fraction, left ventricular end-systolic and end-diastolic volumes were preserved postoperatively. The following Doppler parameters showed significant changes after surgery: mitral A wave (92+/-23 cm/sec vs. 105+/-27 cm/sec, p=0.005), mitral E/A ratio (1.0+/-0.2 vs. 0.8+/-0.2, p=0.001), tricuspid A wave (65+/-19 cm/sec vs. 80+/-30 cm/sec, p=0.006), and tricuspid E deceleration time (327+/-68 msec vs. 274+/-51 msec, p=0.01). Concerning TDI parameters, there were significant differences in mitral E'/A' ratio (1.0+/-0.4 vs. 0.8+/-0.3, p=0.03) and tricuspid E' wave (9+/-2 cm/sec vs. 8+/-3 cm/sec, p=0.03) after surgery.


CONCLUSIONS
Findings of our study suggest that systolic functions are preserved but diastolic functions are affected after major lung resection in a relatively short time period.
Cölkesen
Yücel
Y
Department of Cardiology, Başkent University, Adana, Turkey. kardiyoloji@yahoo.com
Açil
Tayfun
T
Findikçioğlu
Alper
A
Tekin
Abdullah
A
Kiliç
Dalokay
D
Ozin
Bülent
B
Müderrisoğlu
Haldun
H
D015150:Echocardiography, Doppler; D005260:Female; D006321:Heart / Q000502:physiology* / Q000503:physiopathology; D006325:Heart Atria / Q000000981:diagnostic imaging; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology; D011013:Pneumonectomy / Q000009:adverse effects; D011446:Prospective Studies; D013318:Stroke Volume; D014261:Tricuspid Valve / Q000000981:diagnostic imaging / Q000503:physiopathology; D016277:Ventricular Function, Left