Feasibility of speckle-tracking echocardiography for assessment of left ventricular dysfunction after cardiopulmonary bypass.


Journal Article

Effects of temporary biventricular pacing after cardiopulmonary bypass are unpredictable, and the utility of speckle-tracking echocardiography in this setting is unclear. Accordingly, speckle-tracking analysis of transgastric echocardiograms taken during cardiac surgery was assessed as a potential tool to measure strain, synchrony, and twist as indices to predict response.Prospective observational study, in part, with a randomized controlled study of temporary permanent biventricular pacing after cardiopulmonary bypass.Single-center study at university-affiliated tertiary care hospital.Twenty-one cardiac surgery candidates with ejection fraction ≤40% and QRS duration ≥100 ms or who were undergoing double-valve surgery.Transgastric views of the basal, midpapillary, and apical levels of the left ventricle were acquired before and after bypass.Midpapillary sections were analyzable in 38% of patients. The remainder had epicardial borders extending beyond the field of view (24%) or inadequate image quality (38%). Only 9% of basal or apical sections were analyzable. Midpapillary radial strain and synchrony changed insignificantly after bypass. Variation in fractional area change correlated with changes in radial strain (p = 0.041) but not with synchrony.Intraoperative transgastric echocardiography is inadequate for speckle-tracking analysis with current techniques. Intraoperative predictors of temporary biventricular pacing response are lacking.

Full Text

Duke Authors

Cited Authors

  • Wang, A; Cabreriza, SE; Cheng, B; Shanewise, JS; Spotnitz, HM

Published Date

  • February 2014

Published In

Volume / Issue

  • 28 / 1

Start / End Page

  • 31 - 35

PubMed ID

  • 24055281

Pubmed Central ID

  • 24055281

Electronic International Standard Serial Number (EISSN)

  • 1532-8422

International Standard Serial Number (ISSN)

  • 1053-0770

Digital Object Identifier (DOI)

  • 10.1053/j.jvca.2013.04.014


  • eng