title: Evaluation of right ventricular function after cardiac surgery: The importance of tricuspid annular plane systolic excursion and right ventricular ejection fraction.
abstract: The evaluation of right ventricular systolic function is essential to the hemodynamic management of critically ill cardiac patients. Nevertheless, assessment of right ventricular function remains problematic. We sought to analyze the correlation between tricuspid annular plane systolic excursion (TAPSE) and right ventricular ejection fraction (RVEF) in the assessment of global and regional right ventricular function, respectively.
  
  
  
  This was a prospective study of 61 cardiac surgical patients. TAPSE was measured with transthoracic echocardiography and RVEF was obtained by a thermodilution pulmonary artery catheter. Both measurements were estimated simultaneously during the early postoperative period. Patients with previously identified severe tricuspid insufficiency were excluded from the study to avoid confounding results.
  
  
  
  The etiologies for cardiac surgery were surgical pulmonary thromboendarterectomy in 19 patients, valve replacement in 17 patients, heart transplant in 13 patients, and coronary artery bypass graft in 9 patients. Mean RVEF and TAPSE were 26.2% ± 9.7% and 11.4 ± 4 mm, respectively. RVEF and TAPSE showed a significant correlation (r = 0.73, P < .001). Weak reverse relationships between TAPSE or RVEF with afterload hemodynamic parameters, mean pulmonary artery pressure, or pulmonary vascular resistance were elucidated.
  
  
  
  TAPSE is a robust measure of right ventricular function that correlates with RVEF assessed by pulmonary artery catheter. A noninvasive method such as echocardiography can guide and support invasive monitoring of right ventricular function in cardiac surgical patients.
authors.affiliation: Intensive Care Medicine Department, Cardiac Intensive Care Unit Division, Madrid, Spain. Electronic address: rennygg@hotmail.com.
authors.forename: Renata
authors.initials: R
authors.lastname: Garcia Gigorro
authors.affiliation: Intensive Care Medicine Department, Cardiac Intensive Care Unit Division, Madrid, Spain.
authors.forename: Emilio
authors.initials: E
authors.lastname: Renes Carreño
authors.affiliation: Cardiology Department, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: Sandra
authors.initials: S
authors.lastname: Mayordomo
authors.affiliation: Intensive Care Medicine Department, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: Helena
authors.initials: H
authors.lastname: Marín
authors.affiliation: Intensive Care Medicine Department, Cardiac Intensive Care Unit Division, Madrid, Spain.
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Perez Vela
authors.affiliation: Intensive Care Medicine Department, Cardiac Intensive Care Unit Division, Madrid, Spain.
authors.forename: María Angélica
authors.initials: MA
authors.lastname: Corres Peiretti
authors.affiliation: Intensive Care Medicine Department, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Montejo González
mesh_terms: D000328:Adult; D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D002407:Catheterization, Swan-Ganz; D004452:Echocardiography; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013318:Stroke Volume; D013599:Systole; D013815:Thermodilution; D013997:Time Factors; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016278:Ventricular Function, Right
keywords: RVEF; TAPSE; cardiac surgery; right ventricular function; thermodilution catheter