Tissue Doppler evaluation of the right ventricle in major pulmonary resections

Abstract

To analyze the consequences of major pulmonary resections on right ventricle (RV) function by using the tissue Doppler imaging (TDI) technique. Materials and methods: Twenty patients (16 males and 4 females) who received pulmonary resection for primary non-small cell lung cancer underwent echocardiographic examinations before surgery on the 2nd and 7th postoperative days. Results: Tricuspid E wave significantly decreased from the postoperative 2nd day to the 7th day (45.93 ± 8.0 to 35.77 ± 7.4 cm/s; P = 0.02). On the postoperative 2nd and 7th days, tricuspid A wave values (58.27 ± 9.6 and 58.94 ± 8.4 cm/s) were significantly higher compared to preoperative values (45.71 ± 12.2 cm/s; P = 0.02 for both). The S' wave measured at the basal segment of the right ventricle markedly decreased on the postoperative 2nd day (12.35 ± 2.2 to 10.15 ± 3.2 cm/s; P = 0.03). Tricuspid annular S’ wave velocity of patients who underwent pneumonectomy was lower than in patients who underwent lobectomy (10.65 ± 2.4 versus 14.42 ± 3.3 cm/s; P = 0.04). Conclusion: In the early postoperative period, significant dilatation and dysfunction of the RV is caused by pulmonary resection. Early detection of this deterioration by means of this noninvasive technique could make swift interventional therapy possible, which is an important step towards avoiding future right heart failure.