Tissue Doppler Evaluation Of The Effects Of Major Lung Resection On Cardiac Functions

Objectives: The aim of our study was to evaluate the influence of lung resection on cardiac functions by using tissue Doppler echocardiography.Study design: Nineteen consecutive patients (15 males, 4 females; mean age 55 +/- 8 years) undergoing major lung surgery (16 lobectomy, 3 pneumonectomy) were evaluated in a prospective design. Malignant lung cancer (n=15, 79%) was the major cause for lung surgery. Exclusion criteria were a history of myocardial infarction, angina, atrial fibrillation, valvular heart disease, major arrhythmias, diastolic dysfunction, heart surgery, and FEV 1/FVC ratio lower than 60%. Two-dimensional Doppler echocardiography and tissue Doppler imaging (TDI) were performed one or two days before surgery and 4 +/- 2 weeks postoperatively.Results: Compared to the preoperative measurements, right and left atrial and ventricular dimensions did not differ after surgery (p>0.05). Left ventricular ejection fraction, left ventricular end- systolic and end- diastolic volumes were preserved postoperatively. The following Doppler parameters showed significant changes after surgery: mitral A wave (92 +/- 23 cm/sec vs. 105 +/- 27 cm/sec, p=0.005), mitral E/A ratio (1.0 +/- 0.2 vs. 0.8 +/- 0.2, p=0.001), tricuspid A wave (65 +/- 19 cm/sec vs. 80 +/- 30 cm/sec, p=0.006), and tricuspid E deceleration time (327 +/- 68 msec vs. 274 +/- 51 msec, p=0.01). Concerning TDI parameters, there were significant differences in mitral E '/A' ratio (1.0 +/- 0.4 vs. 0.8 +/- 0.3, p=0.03) and tricuspid E' wave (9 +/- 2 cm/sec vs. 8 +/- 3 cm/sec, p=0.03) after surgery.Conclusion: Findings of our study suggest that systolic functions are preserved but diastolic functions are affected after major lung resection in a relatively short time period.