Invasive Mechanical Ventilation Is Associated with Worse Right Ventricular Strain in Acute Respiratory Failure Patients

Wang, Shuyuan; Bashir, Zubair; Chen, Edward W.; Kadiyala, Vishnu; Sherrod, Charles F.; Has, Phinnara; Song, Christopher; Ventetuolo, Corey E.; Simmons, James; Haines, Philip

doi:10.3390/jcdd11080246

Open AccessArticle

Invasive Mechanical Ventilation Is Associated with Worse Right Ventricular Strain in Acute Respiratory Failure Patients

by

Shuyuan Wang

^1,2,†

,

Zubair Bashir

^3,*,†

,

Edward W. Chen

⁴,

Vishnu Kadiyala

³,

Charles F. Sherrod

^5,6,

Phinnara Has

⁷,

Christopher Song

³

,

Corey E. Ventetuolo

^8,9,

James Simmons

⁸

and

Philip Haines

^3,*

¹

Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China

²

Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China

³

Department of Cardiology, Alpert Medical School of Brown University, Providence, RI 02903, USA

⁴

Department of Internal Medicine, Yale School of Medicine, New Haven, CT 06510, USA

⁵

Department of Cardiology, Healthcare Institute for Innovations in Quality, University of Missouri-Kansas City, Kansas City, MO 64110, USA

⁶

Saint Luke’s Mid America Heart Institute, Kansas City, MO 64111, USA

⁷

Lifespan Biostatistics, Epidemiology and Research Design, Rhode Island Hospital, Providence, RI 02903, USA

⁸

Division of Pulmonary, Critical Care, and Sleep Medicine, Alpert Medical School of Brown University, Providence, RI 02903, USA

⁹

Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI 02903, USA

^*

Authors to whom correspondence should be addressed.

^†

These authors contributed equally to this work.

J. Cardiovasc. Dev. Dis. 2024, 11(8), 246; https://doi.org/10.3390/jcdd11080246

Submission received: 21 June 2024 / Revised: 7 August 2024 / Accepted: 7 August 2024 / Published: 9 August 2024

(This article belongs to the Special Issue Critical Care in Modern Cardiology)

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Abstract

Right ventricular (RV) dysfunction is associated with poor prognosis in acute respiratory failure (ARF). Our study evaluates the efficacy of RV strain in detecting RV dysfunction in ARF patients requiring invasive mechanical ventilation (IMV) compared to tricuspid annular plane systolic excursion (TAPSE). In this retrospective study involving 376 patients diagnosed with ARF and requiring IMV, we extracted clinical and outcome data from patient records. RV global longitudinal strain (RVGLS), free wall longitudinal strain (FWLS), and TAPSE were measured retrospectively using speckle tracking echocardiography (STE) and traditional echocardiography, respectively. We divided the cohort into three groups: TTE during IMV (TTE-IMV, 223 patients), before IMV (TTE-bIMV, 68 patients), and after IMV (TTE-aIMV, 85 patients). Multivariable regression analysis, adjusted for covariates, revealed significantly higher RVGLS and FWLS in the groups not on IMV at the time of TTE compared to the TTE-IMV group. Specifically, the TTE-bIMV group showed higher RVGLS (β = 7.28, 95% CI 5.07, 9.48) and FWLS (β = 5.83, 95% CI 3.36, 8.31), while the TTE-aIMV group exhibited higher RVGLS (β = 9.39, 95% CI 6.10, 12.69) and FWLS (β = 7.54, 95% CI 4.83, 10.24). TAPSE did not reveal any significant differences across the groups. Our study suggests an association between IMV and lower RVGLS and FWLS in ARF patients, indicating that IMV itself may contribute to RV dysfunction. RVGLS and FWLS appear to be more sensitive than TAPSE in detecting changes in RV function that were previously subclinical in patients on IMV. Prospective studies with TTE before, during, and after IMV are necessary to assess the primary driver of RV dysfunction and to prognosticate STE-detected RV dysfunction in this population.

Keywords: right ventricular global longitudinal strain; right ventricular free wall longitudinal strain; TAPSE; acute respiratory failure; invasive mechanical ventilation

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MDPI and ACS Style

Wang, S.; Bashir, Z.; Chen, E.W.; Kadiyala, V.; Sherrod, C.F.; Has, P.; Song, C.; Ventetuolo, C.E.; Simmons, J.; Haines, P. Invasive Mechanical Ventilation Is Associated with Worse Right Ventricular Strain in Acute Respiratory Failure Patients. J. Cardiovasc. Dev. Dis. 2024, 11, 246. https://doi.org/10.3390/jcdd11080246

AMA Style

Wang S, Bashir Z, Chen EW, Kadiyala V, Sherrod CF, Has P, Song C, Ventetuolo CE, Simmons J, Haines P. Invasive Mechanical Ventilation Is Associated with Worse Right Ventricular Strain in Acute Respiratory Failure Patients. Journal of Cardiovascular Development and Disease. 2024; 11(8):246. https://doi.org/10.3390/jcdd11080246

Chicago/Turabian Style

Wang, Shuyuan, Zubair Bashir, Edward W. Chen, Vishnu Kadiyala, Charles F. Sherrod, Phinnara Has, Christopher Song, Corey E. Ventetuolo, James Simmons, and Philip Haines. 2024. "Invasive Mechanical Ventilation Is Associated with Worse Right Ventricular Strain in Acute Respiratory Failure Patients" Journal of Cardiovascular Development and Disease 11, no. 8: 246. https://doi.org/10.3390/jcdd11080246

APA Style

Wang, S., Bashir, Z., Chen, E. W., Kadiyala, V., Sherrod, C. F., Has, P., Song, C., Ventetuolo, C. E., Simmons, J., & Haines, P. (2024). Invasive Mechanical Ventilation Is Associated with Worse Right Ventricular Strain in Acute Respiratory Failure Patients. Journal of Cardiovascular Development and Disease, 11(8), 246. https://doi.org/10.3390/jcdd11080246

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Invasive Mechanical Ventilation Is Associated with Worse Right Ventricular Strain in Acute Respiratory Failure Patients

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