Right Ventricular Dysfunction Clinical Trial
Official title:
Early Peri-operative Right Ventricle Dysfunction Following Major Lung Resection
Major lung resection is associated with high post-operative morbidity and mortality and
significant long-term decreased functional capacity, especially due to cardiorespiratory
complications.
RV (Right Ventricle) ejection, pulmonary artery pressure and tone are tightly coupled. The RV
is exquisitely sensitive to changes in afterload. When pulmonary vascular reserve is
compromised RV ejection may be also compromised, increasing right atrial pressure and
limiting maximal cardiac output. Acute increase in RV outflow resistance, as may occur with
acute pulmonary embolism will cause acute RV dilatation and, by ventricular interdependence,
markedly decreased LV (Left Ventricle) compliance, rapidly spiraling to acute cardiogenic
shock and death.
Most of the studies on RV function after lung resection are small and have found different
results, and sometimes conflicting findings. As far as the investigators know, there are no
data on the incidence of the RV dysfunction after major lung resection
(pneumonectomy/bilobectomy) and it's not clear if there is some direct association between
the RV dysfunction and post-operative complications. If so, early detection of RV dysfunction
after major lung resection could provide the opportunity for interventional therapy with
consequent possible improvement of these patients' prognosis.
The aim of this study is to identify the incidence of early RV systolic dysfunction (defined as Tricuspid Annular Plane Systolic Excursion (TAPSE) < 17 cm, S' (TDI) < 10 cm/s) and estimate the RV-PA (Right Ventricle-Pulmonary Artery) coupling as indicated by Guazzi et all. (TAPSE/PAPs ratio, where PAPs is the Systolic Pulmonary Artery Pressure) after major lung resection (bilobectomy and pneumonectomy) using echocardiography, and to assess if these modifications (RV dysfunction and RV-PA coupling) may be associated with post-operative cardiopulmonary complications occurring during the hospitalization period. Investigators also intend to evaluate if these changes are associated with impaired functional capacity at 3 months after surgery. ;
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