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ORIGINAL ARTICLE
Year : 2019  |  Volume : 29  |  Issue : 3  |  Page : 103-110

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


1 Academic Unit of Anaesthesia, Pain and Critical Care Medicine, University of Glasgow, Scotland, United Kingdom
2 Academic Unit of Anaesthesia, Pain and Critical Care Medicine, University of Glasgow; Department of Anaesthesia and Perioperative Medicine, Golden Jubilee National Hospital, Clydebank, Scotland, United Kingdom

Correspondence Address:
Wai Huang Teng
Academic Unit of Anaesthesia, Pain and Critical Care Medicine, Room 2.73, Level 2 New Lister Building, Glasgow Royal Infirmary, Glasgow, G31 2ER, Scotland
United Kingdom
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jcecho.jcecho_19_19

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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.


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