Impact of the right ventricular mechanical pattern assessed by three-dimensional echocardiography on adverse outcomes following cardiac surgery
Abstract Risk stratification for cardiac surgery is a cornerstone of perioperative management. While the prognostic impact of severe right ventricular (RV) dysfunction is well understood, the added value of the RV mechanical pattern regarding risk prediction remains unknown. We sought to prospective...
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Nature Portfolio
2025-02-01
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| Online Access: | https://doi.org/10.1038/s41598-025-89122-w |
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| author | Marius Keller Alexandra Fábián Andrea Bandini Ádám Szijártó Zoltán Tősér Béla Merkely Tim Heller Marcia-Marleen Dürr Peter Rosenberger Attila Kovács Harry Magunia |
| author_facet | Marius Keller Alexandra Fábián Andrea Bandini Ádám Szijártó Zoltán Tősér Béla Merkely Tim Heller Marcia-Marleen Dürr Peter Rosenberger Attila Kovács Harry Magunia |
| author_sort | Marius Keller |
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| description | Abstract Risk stratification for cardiac surgery is a cornerstone of perioperative management. While the prognostic impact of severe right ventricular (RV) dysfunction is well understood, the added value of the RV mechanical pattern regarding risk prediction remains unknown. We sought to prospectively validate the predictive value of 3D RV mechanics for adverse perioperative outcomes. The clinical and echocardiographic parameters of 439 retrospectively selected patients who underwent various types of cardiac surgery and 3D transesophageal echocardiography were investigated to determine their associations with a composite endpoint of an unfavorable postoperative outcome. Tricuspid regurgitation, 2D RV strains, and 3D measures of left ventricular (LV) and RV function were associated with the composite endpoint. Multivariable logistic regression models revealed that only tricuspid regurgitation, LV ejection fraction and 3D RV global longitudinal strain (GLS) were independently associated with the endpoint. By applying the model to the data of 128 prospectively enrolled patients, only 3D RV GLS remained an independent predictor. A RV GLS cutoff of -17.4% was found to be associated with a 3-fold increased risk for adverse outcomes. This led us to conclude that RV longitudinal deformation derived from 3D echocardiography is predictive of adverse outcomes and should be incorporated in perioperative risk stratification. |
| format | Article |
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| institution | OA Journals |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Nature Portfolio |
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| spelling | doaj-art-c3f004bbd9854de8a677cbaaf141cf8a2025-08-20T02:13:14ZengNature PortfolioScientific Reports2045-23222025-02-0115111310.1038/s41598-025-89122-wImpact of the right ventricular mechanical pattern assessed by three-dimensional echocardiography on adverse outcomes following cardiac surgeryMarius Keller0Alexandra Fábián1Andrea Bandini2Ádám Szijártó3Zoltán Tősér4Béla Merkely5Tim Heller6Marcia-Marleen Dürr7Peter Rosenberger8Attila Kovács9Harry Magunia10Department of Anesthesiology and Intensive Care Medicine, Eberhard Karls UniversityHeart and Vascular Center, Semmelweis UniversityDepartment of Anesthesiology and Intensive Care Medicine, Eberhard Karls UniversityHeart and Vascular Center, Semmelweis UniversityArgus Cognitive, IncHeart and Vascular Center, Semmelweis UniversityDepartment of Anesthesiology and Intensive Care Medicine, Eberhard Karls UniversityDepartment of Anesthesiology and Intensive Care Medicine, Eberhard Karls UniversityDepartment of Anesthesiology and Intensive Care Medicine, Eberhard Karls UniversityHeart and Vascular Center, Semmelweis UniversityDepartment of Anesthesiology and Intensive Care Medicine, Eberhard Karls UniversityAbstract Risk stratification for cardiac surgery is a cornerstone of perioperative management. While the prognostic impact of severe right ventricular (RV) dysfunction is well understood, the added value of the RV mechanical pattern regarding risk prediction remains unknown. We sought to prospectively validate the predictive value of 3D RV mechanics for adverse perioperative outcomes. The clinical and echocardiographic parameters of 439 retrospectively selected patients who underwent various types of cardiac surgery and 3D transesophageal echocardiography were investigated to determine their associations with a composite endpoint of an unfavorable postoperative outcome. Tricuspid regurgitation, 2D RV strains, and 3D measures of left ventricular (LV) and RV function were associated with the composite endpoint. Multivariable logistic regression models revealed that only tricuspid regurgitation, LV ejection fraction and 3D RV global longitudinal strain (GLS) were independently associated with the endpoint. By applying the model to the data of 128 prospectively enrolled patients, only 3D RV GLS remained an independent predictor. A RV GLS cutoff of -17.4% was found to be associated with a 3-fold increased risk for adverse outcomes. This led us to conclude that RV longitudinal deformation derived from 3D echocardiography is predictive of adverse outcomes and should be incorporated in perioperative risk stratification.https://doi.org/10.1038/s41598-025-89122-wTransesophageal echocardiographyThree-dimensional echocardiographyRightventricular functionRisk predictionCardiac surgery |
| spellingShingle | Marius Keller Alexandra Fábián Andrea Bandini Ádám Szijártó Zoltán Tősér Béla Merkely Tim Heller Marcia-Marleen Dürr Peter Rosenberger Attila Kovács Harry Magunia Impact of the right ventricular mechanical pattern assessed by three-dimensional echocardiography on adverse outcomes following cardiac surgery Scientific Reports Transesophageal echocardiography Three-dimensional echocardiography Rightventricular function Risk prediction Cardiac surgery |
| title | Impact of the right ventricular mechanical pattern assessed by three-dimensional echocardiography on adverse outcomes following cardiac surgery |
| title_full | Impact of the right ventricular mechanical pattern assessed by three-dimensional echocardiography on adverse outcomes following cardiac surgery |
| title_fullStr | Impact of the right ventricular mechanical pattern assessed by three-dimensional echocardiography on adverse outcomes following cardiac surgery |
| title_full_unstemmed | Impact of the right ventricular mechanical pattern assessed by three-dimensional echocardiography on adverse outcomes following cardiac surgery |
| title_short | Impact of the right ventricular mechanical pattern assessed by three-dimensional echocardiography on adverse outcomes following cardiac surgery |
| title_sort | impact of the right ventricular mechanical pattern assessed by three dimensional echocardiography on adverse outcomes following cardiac surgery |
| topic | Transesophageal echocardiography Three-dimensional echocardiography Rightventricular function Risk prediction Cardiac surgery |
| url | https://doi.org/10.1038/s41598-025-89122-w |
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