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Three Dimensional Speckle Tracking Based Strain Imaging Identifies Alterations in Dynamic Left Ventricular Function after Cardiac Surgery

  • Author(s): Howard-Quijano, Kimberly
  • Advisor(s): Elashoff, Robert M
  • Mahajan, Aman
  • et al.
Abstract

Three-dimensional (3D) echocardiography based strain imaging is an emerging modality to assess dynamic left ventricular function in patients undergoing cardiac surgery. Adult patients undergoing cardiac surgery (n=182) were prospectively imaged with 3D transthoracic echocardiograms (TTE) pre- and post-operatively and analyzed for left ventricular 3D; ejection fraction (EF), global peak systolic area (GAS), longitudinal (GLS), circumferential (GCS), and radial (GRS) strain. 3D strain correlated well with 3D EF. Receiver operating curves identified 3D GAS as the best indicator for ventricular function, with a normal cutoff of -25%. Pre-operative 3D strain was an independent predictor of ICU stay and inotrope score, increasing predictive value of known pre-operative risk factor models, especially in patients with reduced ventricular function. Demonstrating that after cardiac surgery, there is an acute reduction in post-operative left ventricular function that can be accurately measured with 3D speckle tracking strain imaging and strain measures may be predictive of post-operative outcomes.

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