title: Effect of Preload Alterations on Left Ventricular Systolic Parameters Including Speckle-Tracking Echocardiography Radial Strain During General Anesthesia.
abstract: OBJECTIVE
  Frequently used parameters for evaluation of left ventricular systolic function are load-sensitive. However, the impact of preload alterations on speckle-tracking echocardiographic parameters during anesthesia has not been validated. Therefore, two-dimensional (2D) speckle-tracking echocardiography radial strain (RS) was assessed during general anesthesia, simulating 3 different preload conditions.
  
  
  METHODS
  Single-center prospective observational study.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Thirty-three patients with normal left ventricular systolic function undergoing major surgery.
  
  
  METHODS
  Transgastric views of the midpapillary level of the left ventricle were acquired at 3 different positions.
  
  
  RESULTS
  Fractional shortening (FS), fractional area change (FAC), and 2D speckle-tracking echocardiography RS were analyzed in the transgastric midpapillary view. Considerable correlation above 0.5 was found for FAC and FS in the zero and Trendelenburg positions (r = 0.629, r = 0.587), and for RS and FAC in the anti-Trendelenburg position (r = 0.518). In the repeated-measures analysis, significant differences among the values measured at the 3 positions were found for FAC and FS. For FAC, there were differences up to 2.8 percentage points between the anti-Trendelenburg position and the other 2 positions. For FS, only the difference between position zero and anti-Trendelenburg was significant, with an observed change of 1.66. Two-dimensional RS was not significantly different at all positions, with observed changes below 1 percentage point.
  
  
  CONCLUSIONS
  Alterations in preload did not result in clinically relevant changes of RS, FS, or FAC. Observed changes for RS were smallest; however, the variation of RS was larger than that of FS or FAC.
authors.affiliation: Department of Anaesthesiology, General Intensive Care and Pain Control, Medical University of Vienna, Vienna, Austria. Electronic address: Ulrike.weber@meduniwien.ac.at.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Weber
authors.affiliation: Department of Anaesthesiology, General Intensive Care and Pain Control, Medical University of Vienna, Vienna, Austria.
authors.forename: Eva
authors.initials: E
authors.lastname: Base
authors.affiliation: Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria.
authors.forename: Robin
authors.initials: R
authors.lastname: Ristl
authors.affiliation: Department of Anaesthesiology, General Intensive Care and Pain Control, Medical University of Vienna, Vienna, Austria.
authors.forename: Bruno
authors.initials: B
authors.lastname: Mora
mesh_terms: D000328:Adult; D000368:Aged; D000768:Anesthesia, General / Q000009:adverse effects / Q000639:trends*; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000209:etiology; D016277:Ventricular Function, Left / Q000502:physiology*
keywords: radial strain; speckle tracking; transesophageal echocardiography