title: Speckle tracking for the intraoperative assessment of right ventricular function: a feasibility study.
abstract: OBJECTIVE
  Speckle tracking is an ultrasound method that assesses B-mode features to measure tissue displacement and derive deformation parameters. The objective of this study was to assess the feasibility of using speckle tracking in the measurement of right ventricular (RV) longitudinal strain during cardiac surgery using transesophageal echocardiography (TEE).
  
  
  METHODS
  This was a prospective, observational cohort study.
  
  
  METHODS
  A single university hospital setting.
  
  
  METHODS
  Twenty-one patients without valvular disease referred for coronary artery bypass graft surgery were studied.
  
  
  METHODS
  None.
  
  
  RESULTS
  After the induction of anesthesia and mechanical ventilation, transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) were used to obtain tricuspid annular plane systolic excursion (TAPSE), RV fractional area of change (FAC), and 2-dimensional strain analysis (speckle tracking) on 3 consecutive heart beats. There was a larger percentage of measurable segments achieved when using TEE. All segments could be analyzed per cardiac cycle in 73% of loops when using TEE and 38% when using TTE. The global strain value was similar using both methods (TEE: -20.4%, TTE: -20.1%). The TAPSE could be measured in only 52% of the segments using TTE and 100% using TEE. The FAC could be measured in 90.5% of the loops using TEE and in only 33.3% of the loops using TTE.
  
  
  CONCLUSIONS
  Perioperative measurements of RV strain using TEE in ventilated patients is feasible. The success rate was higher using TEE in ventilated patients under anesthesia. Differences between the 2 methods were likely the result of differences in 2-dimensional image quality.
authors.affiliation: Department of Anesthesia, The Keenan Research Center at the Li Ka Shing Knowledge Institute, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Claude
authors.initials: C
authors.lastname: Tousignant
authors.forename: Matthias
authors.initials: M
authors.lastname: Desmet
authors.forename: Richard
authors.initials: R
authors.lastname: Bowry
authors.forename: Alana M
authors.initials: AM
authors.lastname: Harrington
authors.forename: Jorge D
authors.initials: JD
authors.lastname: Cruz
authors.forename: C David
authors.initials: CD
authors.lastname: Mazer
mesh_terms: D000368:Aged; D015331:Cohort Studies; D017548:Echocardiography, Transesophageal / Q000379:methods / Q000592:standards; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods* / Q000592:standards*; D011446:Prospective Studies; D016278:Ventricular Function, Right / Q000502:physiology*