title: Right ventricular strain as predictor of pulmonary complications in patients with femur fracture.
abstract: BACKGROUND
  Following femur fracture, medullary fat enters the systemic circulation and altered pulmonary haemodynamics may contribute to pulmonary complications. This study evaluated the association between right ventricular (RV) function and pulmonary complications in patients with femur fracture.
  
  
  METHODS
  Patients with a femur fracture who had undergone pre-operative echocardiography that included RV peak global longitudinal strain (RV GLS) were evaluated retrospectively between March 2015 and February 2016. Pulmonary complications were defined as the development of pneumonia or pulmonary thromboembolism during the first postoperative month.
  
  
  RESULTS
  Among 78 patients, pulmonary complications developed in eight (10.3%). The RV GLS value of all patients was lower than the normal range. In addition, the RV GLS value of patients with pulmonary complications was significantly lower than that of patients without pulmonary complications. Multivariate regression analyses found that worse RV GLS values independently predicted pulmonary complications [odds ratio (OR) 2.09, 95% confidence interval (CI) 1.047-4.151, p = 0.037]. Receiver operating characteristic curve analysis found that a RV GLS value of -14.85% was the best cut-off value to predict pulmonary complications; sensitivity: 75.0%; specificity: 62.9%. Moreover, patients with RV GLS values > -14.85% had significantly lower pulmonary complication-free survival.
  
  
  CONCLUSIONS
  In patients with femur fracture, RV GLS values could help predict pulmonary complications. Therefore, patients with RV GLS values > -14.85 should be monitored closely before and after surgery for femur fracture.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Myongji Hospital, South Korea; Department of Translational Medicine, College of Medicine, Seoul National University, South Korea. Email: titi8th@gmail.com.
authors.forename: Hyun-Jin
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Myongji Hospital, South Korea.
authors.forename: Hyung-Bok
authors.initials: HB
authors.lastname: Park
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Myongji Hospital, South Korea.
authors.forename: Yongsung
authors.initials: Y
authors.lastname: Suh
authors.affiliation: College of Nursing and Research Institute of Nursing Science, Seoul National University, South Korea.
authors.forename: Hyun-Sun
authors.initials: HS
authors.lastname: Kim
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Myongji Hospital, South Korea.
authors.forename: Yoon-Hyeong
authors.initials: YH
authors.lastname: Cho
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Myongji Hospital, South Korea.
authors.forename: Tae-Young
authors.initials: TY
authors.lastname: Choi
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Myongji Hospital, South Korea.
authors.forename: Eui-Seok
authors.initials: ES
authors.lastname: Hwang
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Myongji Hospital, South Korea.
authors.forename: Deok-Kyu
authors.initials: DK
authors.lastname: Cho
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004452:Echocardiography / Q000379:methods; D005260:Female; D005264:Femoral Fractures / Q000150:complications*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008171:Lung Diseases / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012189:Retrospective Studies; D018497:Ventricular Dysfunction, Right / Q000503:physiopathology*; D016278:Ventricular Function, Right / Q000502:physiology*