Format

Send to

Choose Destination
J Cardiothorac Vasc Anesth. 2015 Aug;29(4):845-51. doi: 10.1053/j.jvca.2015.01.014. Epub 2015 Jan 8.

Speckle-Tracking Strain Imaging Identifies Alterations in Left Atrial Mechanics With General Anesthesia and Positive-Pressure Ventilation.

Author information

1
Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA.
2
Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA. Electronic address: amahajan@mednet.ucla.edu.

Abstract

OBJECTIVES:

The primary aim of this study was to use speckle-tracking strain imaging to evaluate the effect of general anesthesia (GA) and positive-pressure ventilation (PPV) on left atrial (LA) mechanics. The authors hypothesized that GA and PPV would be associated with a decrease in LA strain. The secondary aims were to investigate the effects of GA and PPV on traditional Doppler-derived measures of LA function and Doppler echocardiographic grade of diastolic function.

DESIGN:

A prospective observational study.

SETTING:

A university hospital.

PARTICIPANTS:

Adult patients undergoing cardiac surgery.

INTERVENTIONS:

Transthoracic echocardiography was performed at baseline and under GA with PPV.

MEASUREMENTS AND MAIN RESULTS:

Changes in LA function associated with GA and PPV were assessed using LA speckle-tracking strain imaging. A reduction was observed in LA peak longitudinal strain (24% v 18%, p<0.001) and preatrial contraction strain (13% v 8%, p<0.001). No difference was seen in LA contraction strain or atrial ejection fraction. Indexed LA volume and Doppler diastolic indices also were reduced significantly, and 39% of patients had a change in measured diastolic grade under GA with PPV.

CONCLUSIONS:

Speckle-tracking strain imaging of the left atrium demonstrated that GA and PPV had a significant impact on LA mechanics by decreasing strain measures of LA preload, with a lesser effect on LA contractility.

KEYWORDS:

cardiac surgery; left atrial mechanics; speckle tracking; strain; transthoracic echocardiography

PMID:
25990266
DOI:
10.1053/j.jvca.2015.01.014
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center