The utility of eccentricity index as a measure of right ventricular function in a lung resection cohort

McCall, P. and Shelley, B. (2019) The utility of eccentricity index as a measure of right ventricular function in a lung resection cohort. Journal of Cardiovascular Echography, 29(3), pp. 103-110. (doi: 10.4103/jcecho.jcecho_19_19) (PMID:31728300) (PMCID:PMC6829759)

Abstract

Context: Right ventricular (RV) dysfunction occurs after lung resection and is associated with postoperative morbidity. Noninvasive evaluation of the RV is challenging, particularly in the postoperative period. A reliable measure of RV function would have value in this population. Aims: This study compares eccentricity index (EI) obtained by transthoracic echocardiography (TTE) with cardiovascular magnetic resonance (CMR) determined measures of RV function in a lung resection cohort. CMR is the reference method for noninvasive assessment of RV function. Design and Setting: Prospective observational cohort study at a single tertiary hospital. Materials and Methods: Twenty-eight patients scheduled for elective lung resection underwent contemporaneous TTE and CMR imaging preoperatively, on postoperative day (POD) 2 and at 2-month. Systolic and diastolic EI was measured offline from anonymized and randomized TTE and CMR images. Statistical Analysis: Bland–Altman analysis was performed to determine agreement between EITTE and EICMR. Changes over time and comparison with CMR determined RV ejection fraction (RVEFCMR) was assessed. Results: Bland–Altman analysis showed a negligible mean difference between EITTE and EICMR, but limits of agreement were wide (SD 0.24 and 0.28). There were no significant changes in EITTE and EICMR over time (P > 0.35). We found no association between EITTE with RVEFCMR at all-time points (P > 0.22). Systolic and diastolic EICMR on POD 2 demonstrated moderate association with RVEFCMR (r = −0.54 and r = −0.59, P ≤ 0.01). At 2-month, only diastolic EICMR correlated with RVEFCMR (r = −0.43, P = 0.03). There were no meaningful associations between EITTE and EICMR with TTE-derived RV systolic pressure (P > 0.31). Conclusions: TTE determined EI is not useful as a noninvasive method of assessing RV function following lung resection.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Shelley, Dr Benjamin and McCall, Dr Philip
• Authors: McCall, P., and Shelley, B.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Journal of Cardiovascular Echography
• Publisher: Medknow Publications
• ISSN: 2211-4122
• ISSN (Online): 2347-193X
• Copyright Holders: Copyright © 2019 Medknow Publications and Media Pvt. Ltd. and The Italian Society for Cardiovascular Echography (SIEC)
• First Published: First published in Journal of Cardiovascular Echography 29(3):103-110
• Publisher Policy: Reproduced under a Creative Commons License