A Prospective Study of Right Ventricular Function After Coronary Artery Bypass Grafting: Are Usual Echocardiographic Parameters Useful?

Abstract
Background: The best method for accurately assessing the right ventricle (RV) after coronary artery bypass grafting (CABG) remains controversial. In this study, we aimed to investigate several echocardiographic RV function indices to determine which are most effective in evaluating RV function post-CABG. Objectives: Here, we aimed to assess RV functional parameters after CABG using echocardiography. Methods: This prospective before-after study was conducted on 60 patients scheduled for CABG. The patients were assessed before and six weeks after CABG using standard echocardiography and Speckle-Tracking Echocardiography (STE). The significance of changes in study parameters was evaluated using the paired t-test or the non-parametric Wilcoxon test. Two-sided P-values ≤ 0.05 were considered statistically significant. Statistical analysis was performed using SPSS software, version 16.0. Results: Six weeks after CABG, we found significant changes in two parameters: Tricuspid annular plane systolic excursion (TAPSE) and S’ tissue Doppler imaging (20.82 ± 2.53 vs. 14.60 ± 1.84, P = 0.01; 11.79 ± 1.99 vs. 8.80 ± 0.88, P = 0.01, respectively). However, no significant changes occurred in the right ventricular global 2D longitudinal strain or free wall longitudinal strain (-18.83 ± 2.88 vs. -18.79 ± 2.66, P = 0.88; -21.29 ± 3.36 vs. -20.86 ± 3.17, P = 0.12, respectively). Conclusions: TAPSE and S’ tissue Doppler imaging indices change following CABG and cannot be considered standard echocardiographic parameters for assessing RV function after the procedure. However, the two major parameters for right ventricular functional assessment, global 2D longitudinal strain and free wall longitudinal strain, may be less affected by CABG and thus could be more reliable as standard parameters.
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