Regional differences in color tissue Doppler-derived measures of longitudinal right ventricular function using transesophageal and transthoracic echocardiography

Objective: This study was designed to compare the right ventricular (RV) Doppler tissue imaging parameters of tricuspid annular isovolumic acceleration (IVA), systolic velocity (S), and basilar myocardial strain and strain rate (SR) by using both transesophageal echocardiography (TEE) (inferior wall) and transthoracic echocardiography (TTE) (free wall) in a cardiac surgical population under general anesthesia. Design: Prospective observational study. Setting: University hospital. Participants: Twenty-four elective patients undergoing coronary artery bypass surgery. Interventions: None. Measurements and Main Results: Under general anesthesia, simultaneous Doppler tissue-imaging measurements of tricuspid annular velocities and basilar myocardial deformation were performed by using both TEE and TTE approaches. Interclass correlation coefficients were used to compare the measurements using both methods. When TEE and TTE methods were compared, there was good correlation for the IVA (r = 0.70) but no correlation for S-wave velocities, strain, and SR. The S-wave velocities were lower using the TEE approach. The basilar strain and SR were higher using the TEE approach. Conclusions: In cardiac surgical patients under anesthesia, the IVA appears to be the most consistent variable in the evaluation of RV function measured by either the TTE (lateral wall) or TEE (inferior wall). Technical difficulties may preclude the use of the deformation parameters in the assessment of RV function. (c) 2008 Elsevier Inc. All rights reserved.