Comparison of right ventricular function between three-dimensional transesophageal echocardiography and pulmonary artery catheter （３次元経食道心エコーと肺動脈カテーテルによる右心機能測定の比較
著者
矢野, 喜一
(Yano, Kiichi)
上位タイトル
Journal of cardiothoracic and vascular anesthesia
Vol.35,
No.6
(2021.
6)
,p.1663-
1669
識別番号
ISSN
1053-0770
DOI
10.1053/j.jvca.2020.11.012
その他
PMID:33268041
博士論文情報
学位授与番号
10107A558
学位授与年月日
2021-03-25
学位名
博士（医学）
学位授与機関
旭川医科大学
抄録
Objective: This study aimed to compare measurements of right ventricular function using three-dimensional transesophageal echocardiography (3D TEE), and pulmonary artery catheters (PACs) in patients undergoing cardiac surgery. The authors examined the practicality of using the 3D TEE.
Design: Prospective observational.
Setting: Cardiac operating room at a single university hospital.
Participants: All adult patients undergoing elective cardiac surgery at a single tertiary care university hospital over two years.
Interventions: None.
Measurements and main results: Right ventricular end-diastolic volume (RVEDV), right ventricular end-systolic volume (RVESV), stroke volume (SV), and right ventricular ejection fraction (RVEF) were measured with both 3D TEE and PACs. Assessments were performed using correlation coefficients, paired t tests, and Bland-Altman plots. Thirty-one patients participated in this study. Each measurement showed good agreement. RVEDV and RVESV were slightly lower on 3D TEE than on PAC (205.9 mL v 220.2 mL, p = 0.0018; 143.0 mL v 155.5 mL, p = 0.0143, respectively), whereas no significant differences were observed for SV and RVEF (31.0% v 31.1%, p = 0.0569; 61.6 mL v 66.9 mL, p = 0.92, respectively). Linear regression analysis showed high correlation between 3D TEE and PAC for RVEDV (r = 0.87) and RVESV (r = 0.81), and moderate correlation for SV (r = 0.67) and RVEF (r = 0.67). In the Bland-Altman plot, most patients were within the 95% limits of the agreement throughout all measurements.
Conclusion: A high correlation was found between measurements made with a PAC and with 3D TEE in the assessment of right ventricular function. Three-dimensional TEE would be a potential alternative to PAC for assessment of right ventricular function during intraoperative periods.
