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Complexity of changes in right ventricular morphology and function in patients undergoing cardiac surgery - 3D echocardiographic study.

BACKGROUND
An impairment of standard echocardiographic parameters of right ventricular (RV) function is a known phenomenon in patients undergoing cardiac surgery, but its significance remains to be clarified.


AIMS
To assess changes in RV function in patients undergoing cardiac surgery using speckle tracking and 3D echocardiography.


METHODS
The study population comprised 122 patients, referred for cardiac surgery. Transthoracic echocardiographic (TTE) examinations were performed: before the surgery (TTE1), 1 week after surgery (TTE2) and 1 year after the surgery (TTE 3). Parameters measured during these examinations included both standard and advanced indices of RV size and function, as well as a new parameter introduced by our team -RV shortening fraction (RVSF).


RESULTS
TTE1 was performed on average (standard deviation [SD]) 24 (15) hours prior to surgery, whereas TTE2 and TTE3 were performed on average 7.2 (3) days and 346 (75) days after the surgery, respectively. A postoperative impairment of parameters of RV longitudinal function was observed (P <0.001). However, neither RV size assessed by both 2D and 3D technique changed, nor the global RV function measured with the use of fractional area change and ejection fraction. Additionally during the postoperative period an increase in the value of a RVSF by 12.9% was observed. After 12 months we observed an improvement in the parameters of the longitudinal RV function.


CONCLUSIONS
Uncomplicated cardiac surgery causes transient impairment of the longitudinal systolic RV function, with no influence on the global RV function. The preservation of global function results from increased RVSF. After 12 months, an improvement of the longitudinal function can be observed.