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A COMPARATIVE ASSESSMENT OF TRANSESOPHAGEAL AND TRANSTHORACIC ECHOCARDIOGRAPHY FOR ANALYSIS OF RIGHT VENTRICULAR DEFORMATION

Year 2022, Volume: 24 Issue: 1, 8 - 15, 30.04.2022
https://doi.org/10.24938/kutfd.918951

Abstract

Objective: The transthoracic echocardiography (TTE) is the primary method to evaluate the right ventricular (RV) functions, but the assessment of the RV by TTE can be difficult due to the complex structural and anatomical position of the RV. The transesophageal echocardiography (TEE) is a good alternative to TTE when faced with difficulties in obtaining images. In this study, we investigated the agreement between TTE and TEE for the evaluation of the RV functions.
Material and Methods: This study was carried out on 78 patients between January 2017 and May 2017. The TTE and TEE records of the patients were compared by using Bland Altman analysis, and the mean difference and confidence interval between them were analyzed.
Results: Seventy-eight patients were involved in this study. The mean age of patients was 42 years, and 34% of the participants were female. In Bland Altman analysis, there was a moderate agreement between TTE and TEE in terms of mean difference of the E velocity, the A velocity, E’, A’. In contrast, there was a good agreement between TTE and TEE in terms of mean difference of RV strain, RV strain rate E, RV strain rate A, RV strain rate S which means that it could be appropriate to use them interchangeably.
Conclusion: The deformation parameters are essential for analyzing the RV functions, making a clinical decision, and estimating adverse events. The deformation parameters measured using TEE may yield information as accurate and useful as those measured using TTE, and they may be used interchangeably in making a clinical decision.

References

  • 1. Bosch L, Lam CS, Gong L, Chan SP, Sim D, Yeo D et al. Right ventricular dysfunction in left‐sided heart failure with preserved versus reduced ejection fraction. Eur J Heart Fail 2017;19(12):1664-71.
  • 2. Mauermann E, Vandenheuvel M, François K, Bouchez S, Wouters P. Right ventricular systolic assessment by transesophageal versus transthoracic echocardiography: displacement, velocity, and myocardial deformation. J Cardiothorac Vasc Anesth. 2020;3(8):2152-61.
  • 3. Markley RR, Ali A, Potfay J, Paulsen W, Jovin IS. Echocardiographic evaluation of the right heart. J Cardiovasc Ultrasound. 2016;24(3):183-90.
  • 4. Cameli M, Righini FM, Lisi M, Mondillo S. Right ventricular strain as a novel approach to analyze right ventricular performance in patients with heart failure. Heart Fail Rev. 2014;19(5):603-10.
  • 5. Tadic M, Baudisch A, Hassfeld S, Heinzel F, Cuspidi C, Burkhardt F et al. Right ventricular function and mechanics in chemotherapy- and radiotherapy-naive cancer patients. Int J Cardiovasc Imaging. 2018;34:1581-7.
  • 6. Carroll BJ, Heidinger BH, Dabreo DC, Matos JD, Mohebali D, Feldman SA et al. Multimodality assessment of right ventricular strain in patients with acute pulmonary embolism. Am J Cardiol. 2018;122(1):175-81.
  • 7. Badran HM, Ahmed MK, Beshay MM, Zein FEA. A comparative study between transthoracic and transesophageal echo modalities in evaluation of left ventricular deformation. Egypt Heart J. 2019;71(1):4.
  • 8. Grayburn PA, She L, Roberts BJ, Golba KS, Mokrzycki K, Drozdz J et al. Comparison of transesophageal and transthoracic echocardiographic measurements of mechanism and severity of mitral regurgitation in ischemic cardiomyopathy (from the Surgical Treatment of Ischemic Heart Failure Trial). Am J Cardiol. 2015;116(6):913-8.
  • 9. Minami T, Kawano H, Yamachika S, Tsuneto A, Kaneko M, Kawano Y et al. Comparison of the diagnostic power of transthoracic and transesophageal echocardiography to detect ruptured chordae tendineae. Int Heart J. 2012;53(4):225-9.
  • 10. Wong D, Keynan Y, Rubinstein E. Comparison between transthoracic and transesophageal echocardiography in screening for infective endocarditis in patients with Staphylococcus aureus bacteremia. Eur J Clin Microbiol Infect Dis. 2014;33(11):2053-9.
  • 11. Rudski LG, Lai WW, Afilalo J, Hua L, Handschumacher MD, Chandrasekaran K et al. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography: endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr. 2010;23(7):685-713.
  • 12. Sanz J, Sánchez-Quintana D, Bossone E, Bogaard HJ, Naeije R. Anatomy, function, and dysfunction of the right ventricle: JACC state-of-the-art review. J Am Coll Cardiol. 2019;73(12):1463-82.
  • 13. Tannus-Silva DG, Rabahi MF. State of the art review of the right ventricle in COPD patients: It is time to look closer. Lung. 2017;195(1):9-17.
  • 14. Kasprzak JD, Huttin O, Wierzbowska-Drabik K, Selton-Suty C. Imaging the right heart-pulmonary circulation unit: The role of ultrasound. Heart Fail Clin. 2018;14(3):361-76.
  • 15. Xu Q, Sun L, Zhou W, Tang Y, Ding Y, Huang J et al. Evaluation of right ventricular myocardial strains by speckle tracking echocardiography after percutaneous device closure of atrial septal defects in children. Echocardiography. 2018;35(8):1183-8.
  • 16. Luo R, Cui H, Huang D, Sun L, Song S, Sun M et al. Early assessment of right ventricular function in Systemic Lupus Erythematosus patients using strain and strain rate imaging. Arq Bras Cardiol. 2018;111:75-81.
  • 17. Karabağ Y, Balcı B, Kaya Y. Kronik obstrüktif akciğer hastalığı olan hastalarda ekokardiyografik sağ ventrikül deformasyon parametrelerinin değerlendirilmesi. Koşuyolu Heart Journal. 2018;21(2):163-8.
  • 18. Naqvi TZ. Echocardiography in transcatheter aortic (core) Valve implantation: Part 2-Transesophageal echocardiography. Echocardiography. 2018;35(7):1020-41.
  • 19. Afonso L, Kottam A, Reddy V, Penumetcha A. Echocardiography in infective endocarditis: State of the art. Curr Cardiol Rep. 2017;19(12):127.
  • 20. Correale M, Ieva R, Manuppelli V, Rinaldi A, Di Biase M. Controversies in echocardiography: 2D vs 3D vs 4D. Minerva Cardioangiol. 2009;57(4):443-55.
  • 21. Roberts SM, Klick J, Fischl A, King TS, Cios TJ. A Comparison of transesophageal to transthoracic echocardiographic measures of right ventricular function. J Cardiothorac and Vasc Anesth. 2020;34(5);1252-9.
  • 22. Kabirdas D, Scridon C, Brenes JC, Hernandez AV, Novaro GM, Asher CR. Accuracy of transthoracic echocardiography for the measurement of the ascending aorta: comparison with transesophageal echocardiography. Clin Cardiol. 2010;33(8):502-7.
  • 23. Levin DN, Taras J, Taylor K. The cost effectiveness of transesophageal echocardiography for pediatric cardiac surgery: a systematic review. Paediatr Anaesth. 2016;26(7):682-93.
  • 24. Takeda H, Muro T, Saito T, Hyodo E, Ehara S, Hanatani A, et al. Diagnostic accuracy of transthoracic and transesophageal echocardiography for the diagnosis of bicuspid aortic valve: comparison with operative findings. Osaka City Med J. 2013;59(2):69-78.
  • 25. Sokalskis V, Peluso D, Jagodzinski A, Sinning C. Added clinical value of applying myocardial deformation imaging to assess right ventricular function. Echocardiography. 2017;34(6):919-27.
  • 26. Aksakal E, Kayal A, Bakirci EM, Kurtl M, Sevimli S, Açikel M. Assessment of agreement between transthoracic and transesophageal echocardiography techniques for left ventricular longitudinal deformation imaging and conventional Doppler parameters estimation: a cross-sectional study. Anatolian J Cardiology. 2012;12(6):472-9.
  • 27. Kurt M, Tanboga IH, Isik T, Kaya A, Ekinci M, Bilen E et al. Comparison of transthoracic and transesophageal 2-dimensional speckle tracking echocardiography. J Cardiothorac and Vasc Anesth. 2012;26(1):26-31.
  • 28. Aksakal E. Strain/Strain Rate Ekokardiyografi. Atatürk Üniversitesi Tıp Fakültesi Dergisi. 2005;37(1):7-13.
  • 29. Ho CY, Solomon SD. A clinician’s guide to tissue Doppler imaging. Circulation. 2006;113(10):e396-e8.
  • 30. Cong Z, Jiang B, Lu J, Cong Y, Fu J, Jin M et al. A potentially new phase of the cardiac cycle: Pre-isovolumic contraction recognized by echocardiography. Medicine. 2018;97(21, e10770):1-8.

Sağ Ventriküler Deformasyon Analizi İçin Transözofageal ve Transtorasik Ekokardiyografinin Karşılaştırmalı Değerlendirmesi

Year 2022, Volume: 24 Issue: 1, 8 - 15, 30.04.2022
https://doi.org/10.24938/kutfd.918951

Abstract

Amaç: Transtorasik ekokardiyografi (TTE), sağ ventrikülün (SV) boyut ve fonksiyonunu değerlendirmek için birincil yöntemdir, ancak SV’nin karmaşık yapısal ve anatomik konumu nedeniyle TTE ile değerlendirilmesi güç olabilir. Transözofageal ekokardiyografi (TÖE), görüntü elde etmede zorluklarla karşılaşıldığında TTE’ye iyi bir alternatif olarak tercih edilmektedir. Bu çalışmada, RV işlevlerinin değerlendirilmesi için TTE ve TÖE arasındaki uyumu araştırdık.
Gereç ve Yöntemler: Bu çalışma Ocak 2017 ile Mayıs 2017 arasında 78 hasta üzerinde gerçekleştirildi. Hastaların TTE ve TEE kayıtları Bland Altman analizi ile karşılaştırılarak aralarındaki ortalama farkları ve güven aralığı analiz edildi.
Bulgular: Bu çalışmaya 78 hasta katıldı. Hastaların ortalama yaşı 42 idi ve katılımcıların% 34'ü kadındı. Bland Altman analizinde, E dalga velositesi, A dalga velositesi, E’ ve A’ değerleri ortalama farkları açısından, TTE ve TÖE arasında orta düzeyde bir uyum vardı. Bunun tersine, TTE ve TÖE arasında SV gerinim, SV gerinim hızı E, SV gerinim hızı A, SV gerinim hızı S değerlerinin ortalama farkları açısından iyi bir anlaşma vardı. Bu da her iki yöntemin birbirinin yerine kullanılmasının uygun olabileceği anlamına geliyordu.
Sonuç: Deformasyon parametreleri, SV işlevlerini analiz etmek, klinik bir karar vermek ve istenmeyen olayları tahmin etmek için gereklidir. TÖE kullanılarak ölçülen deformasyon parametreleri, TTE kullanılarak ölçülen bilgiler kadar doğru ve faydalı bilgi verebilir ve bu iki yöntem klinik bir karar vermede birbirinin yerine kullanılabilir.

References

  • 1. Bosch L, Lam CS, Gong L, Chan SP, Sim D, Yeo D et al. Right ventricular dysfunction in left‐sided heart failure with preserved versus reduced ejection fraction. Eur J Heart Fail 2017;19(12):1664-71.
  • 2. Mauermann E, Vandenheuvel M, François K, Bouchez S, Wouters P. Right ventricular systolic assessment by transesophageal versus transthoracic echocardiography: displacement, velocity, and myocardial deformation. J Cardiothorac Vasc Anesth. 2020;3(8):2152-61.
  • 3. Markley RR, Ali A, Potfay J, Paulsen W, Jovin IS. Echocardiographic evaluation of the right heart. J Cardiovasc Ultrasound. 2016;24(3):183-90.
  • 4. Cameli M, Righini FM, Lisi M, Mondillo S. Right ventricular strain as a novel approach to analyze right ventricular performance in patients with heart failure. Heart Fail Rev. 2014;19(5):603-10.
  • 5. Tadic M, Baudisch A, Hassfeld S, Heinzel F, Cuspidi C, Burkhardt F et al. Right ventricular function and mechanics in chemotherapy- and radiotherapy-naive cancer patients. Int J Cardiovasc Imaging. 2018;34:1581-7.
  • 6. Carroll BJ, Heidinger BH, Dabreo DC, Matos JD, Mohebali D, Feldman SA et al. Multimodality assessment of right ventricular strain in patients with acute pulmonary embolism. Am J Cardiol. 2018;122(1):175-81.
  • 7. Badran HM, Ahmed MK, Beshay MM, Zein FEA. A comparative study between transthoracic and transesophageal echo modalities in evaluation of left ventricular deformation. Egypt Heart J. 2019;71(1):4.
  • 8. Grayburn PA, She L, Roberts BJ, Golba KS, Mokrzycki K, Drozdz J et al. Comparison of transesophageal and transthoracic echocardiographic measurements of mechanism and severity of mitral regurgitation in ischemic cardiomyopathy (from the Surgical Treatment of Ischemic Heart Failure Trial). Am J Cardiol. 2015;116(6):913-8.
  • 9. Minami T, Kawano H, Yamachika S, Tsuneto A, Kaneko M, Kawano Y et al. Comparison of the diagnostic power of transthoracic and transesophageal echocardiography to detect ruptured chordae tendineae. Int Heart J. 2012;53(4):225-9.
  • 10. Wong D, Keynan Y, Rubinstein E. Comparison between transthoracic and transesophageal echocardiography in screening for infective endocarditis in patients with Staphylococcus aureus bacteremia. Eur J Clin Microbiol Infect Dis. 2014;33(11):2053-9.
  • 11. Rudski LG, Lai WW, Afilalo J, Hua L, Handschumacher MD, Chandrasekaran K et al. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography: endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr. 2010;23(7):685-713.
  • 12. Sanz J, Sánchez-Quintana D, Bossone E, Bogaard HJ, Naeije R. Anatomy, function, and dysfunction of the right ventricle: JACC state-of-the-art review. J Am Coll Cardiol. 2019;73(12):1463-82.
  • 13. Tannus-Silva DG, Rabahi MF. State of the art review of the right ventricle in COPD patients: It is time to look closer. Lung. 2017;195(1):9-17.
  • 14. Kasprzak JD, Huttin O, Wierzbowska-Drabik K, Selton-Suty C. Imaging the right heart-pulmonary circulation unit: The role of ultrasound. Heart Fail Clin. 2018;14(3):361-76.
  • 15. Xu Q, Sun L, Zhou W, Tang Y, Ding Y, Huang J et al. Evaluation of right ventricular myocardial strains by speckle tracking echocardiography after percutaneous device closure of atrial septal defects in children. Echocardiography. 2018;35(8):1183-8.
  • 16. Luo R, Cui H, Huang D, Sun L, Song S, Sun M et al. Early assessment of right ventricular function in Systemic Lupus Erythematosus patients using strain and strain rate imaging. Arq Bras Cardiol. 2018;111:75-81.
  • 17. Karabağ Y, Balcı B, Kaya Y. Kronik obstrüktif akciğer hastalığı olan hastalarda ekokardiyografik sağ ventrikül deformasyon parametrelerinin değerlendirilmesi. Koşuyolu Heart Journal. 2018;21(2):163-8.
  • 18. Naqvi TZ. Echocardiography in transcatheter aortic (core) Valve implantation: Part 2-Transesophageal echocardiography. Echocardiography. 2018;35(7):1020-41.
  • 19. Afonso L, Kottam A, Reddy V, Penumetcha A. Echocardiography in infective endocarditis: State of the art. Curr Cardiol Rep. 2017;19(12):127.
  • 20. Correale M, Ieva R, Manuppelli V, Rinaldi A, Di Biase M. Controversies in echocardiography: 2D vs 3D vs 4D. Minerva Cardioangiol. 2009;57(4):443-55.
  • 21. Roberts SM, Klick J, Fischl A, King TS, Cios TJ. A Comparison of transesophageal to transthoracic echocardiographic measures of right ventricular function. J Cardiothorac and Vasc Anesth. 2020;34(5);1252-9.
  • 22. Kabirdas D, Scridon C, Brenes JC, Hernandez AV, Novaro GM, Asher CR. Accuracy of transthoracic echocardiography for the measurement of the ascending aorta: comparison with transesophageal echocardiography. Clin Cardiol. 2010;33(8):502-7.
  • 23. Levin DN, Taras J, Taylor K. The cost effectiveness of transesophageal echocardiography for pediatric cardiac surgery: a systematic review. Paediatr Anaesth. 2016;26(7):682-93.
  • 24. Takeda H, Muro T, Saito T, Hyodo E, Ehara S, Hanatani A, et al. Diagnostic accuracy of transthoracic and transesophageal echocardiography for the diagnosis of bicuspid aortic valve: comparison with operative findings. Osaka City Med J. 2013;59(2):69-78.
  • 25. Sokalskis V, Peluso D, Jagodzinski A, Sinning C. Added clinical value of applying myocardial deformation imaging to assess right ventricular function. Echocardiography. 2017;34(6):919-27.
  • 26. Aksakal E, Kayal A, Bakirci EM, Kurtl M, Sevimli S, Açikel M. Assessment of agreement between transthoracic and transesophageal echocardiography techniques for left ventricular longitudinal deformation imaging and conventional Doppler parameters estimation: a cross-sectional study. Anatolian J Cardiology. 2012;12(6):472-9.
  • 27. Kurt M, Tanboga IH, Isik T, Kaya A, Ekinci M, Bilen E et al. Comparison of transthoracic and transesophageal 2-dimensional speckle tracking echocardiography. J Cardiothorac and Vasc Anesth. 2012;26(1):26-31.
  • 28. Aksakal E. Strain/Strain Rate Ekokardiyografi. Atatürk Üniversitesi Tıp Fakültesi Dergisi. 2005;37(1):7-13.
  • 29. Ho CY, Solomon SD. A clinician’s guide to tissue Doppler imaging. Circulation. 2006;113(10):e396-e8.
  • 30. Cong Z, Jiang B, Lu J, Cong Y, Fu J, Jin M et al. A potentially new phase of the cardiac cycle: Pre-isovolumic contraction recognized by echocardiography. Medicine. 2018;97(21, e10770):1-8.
There are 30 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Articles
Authors

Pınar Demir Gündoğmuş 0000-0001-8042-189X

Kamuran Kalkan 0000-0002-1779-560X

Uğur Aksu 0000-0003-0918-5032

Emrah Aksakal 0000-0001-5765-4281

Oğuzhan Birdal This is me 0000-0002-0667-2516

Publication Date April 30, 2022
Submission Date April 18, 2021
Published in Issue Year 2022 Volume: 24 Issue: 1

Cite

APA Demir Gündoğmuş, P., Kalkan, K., Aksu, U., Aksakal, E., et al. (2022). A COMPARATIVE ASSESSMENT OF TRANSESOPHAGEAL AND TRANSTHORACIC ECHOCARDIOGRAPHY FOR ANALYSIS OF RIGHT VENTRICULAR DEFORMATION. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi, 24(1), 8-15. https://doi.org/10.24938/kutfd.918951
AMA Demir Gündoğmuş P, Kalkan K, Aksu U, Aksakal E, Birdal O. A COMPARATIVE ASSESSMENT OF TRANSESOPHAGEAL AND TRANSTHORACIC ECHOCARDIOGRAPHY FOR ANALYSIS OF RIGHT VENTRICULAR DEFORMATION. Kırıkkale Uni Med J. April 2022;24(1):8-15. doi:10.24938/kutfd.918951
Chicago Demir Gündoğmuş, Pınar, Kamuran Kalkan, Uğur Aksu, Emrah Aksakal, and Oğuzhan Birdal. “A COMPARATIVE ASSESSMENT OF TRANSESOPHAGEAL AND TRANSTHORACIC ECHOCARDIOGRAPHY FOR ANALYSIS OF RIGHT VENTRICULAR DEFORMATION”. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi 24, no. 1 (April 2022): 8-15. https://doi.org/10.24938/kutfd.918951.
EndNote Demir Gündoğmuş P, Kalkan K, Aksu U, Aksakal E, Birdal O (April 1, 2022) A COMPARATIVE ASSESSMENT OF TRANSESOPHAGEAL AND TRANSTHORACIC ECHOCARDIOGRAPHY FOR ANALYSIS OF RIGHT VENTRICULAR DEFORMATION. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi 24 1 8–15.
IEEE P. Demir Gündoğmuş, K. Kalkan, U. Aksu, E. Aksakal, and O. Birdal, “A COMPARATIVE ASSESSMENT OF TRANSESOPHAGEAL AND TRANSTHORACIC ECHOCARDIOGRAPHY FOR ANALYSIS OF RIGHT VENTRICULAR DEFORMATION”, Kırıkkale Uni Med J, vol. 24, no. 1, pp. 8–15, 2022, doi: 10.24938/kutfd.918951.
ISNAD Demir Gündoğmuş, Pınar et al. “A COMPARATIVE ASSESSMENT OF TRANSESOPHAGEAL AND TRANSTHORACIC ECHOCARDIOGRAPHY FOR ANALYSIS OF RIGHT VENTRICULAR DEFORMATION”. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi 24/1 (April 2022), 8-15. https://doi.org/10.24938/kutfd.918951.
JAMA Demir Gündoğmuş P, Kalkan K, Aksu U, Aksakal E, Birdal O. A COMPARATIVE ASSESSMENT OF TRANSESOPHAGEAL AND TRANSTHORACIC ECHOCARDIOGRAPHY FOR ANALYSIS OF RIGHT VENTRICULAR DEFORMATION. Kırıkkale Uni Med J. 2022;24:8–15.
MLA Demir Gündoğmuş, Pınar et al. “A COMPARATIVE ASSESSMENT OF TRANSESOPHAGEAL AND TRANSTHORACIC ECHOCARDIOGRAPHY FOR ANALYSIS OF RIGHT VENTRICULAR DEFORMATION”. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi, vol. 24, no. 1, 2022, pp. 8-15, doi:10.24938/kutfd.918951.
Vancouver Demir Gündoğmuş P, Kalkan K, Aksu U, Aksakal E, Birdal O. A COMPARATIVE ASSESSMENT OF TRANSESOPHAGEAL AND TRANSTHORACIC ECHOCARDIOGRAPHY FOR ANALYSIS OF RIGHT VENTRICULAR DEFORMATION. Kırıkkale Uni Med J. 2022;24(1):8-15.

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