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Evaluation of myocardial work changes after lung resection—the significance of surgical approach: an echocardiographic comparison between VATS and thoracotomy

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Abstract

Objective

Considering the controversial benefits of video-assisted thoracoscopic surgery (VATS), we intended to evaluate the impact of surgical approach on cardiac function after lung resection using myocardial work analysis.

Methods

Echocardiographic data of 48 patients (25 thoracotomy vs. 23 VATS) were retrospectively analyzed. All patients underwent transthoracic echocardiography (TTE) within 2 weeks before and after surgery, including two-dimensional speckle tracking and tissue Doppler imaging.

Results

No notable changes in left ventricular (LV) function, assessed mainly using the LV global longitudinal strain (GLS), global myocardial work index (GMWI), and global work efficiency (GWE), were observed. Right ventricular (RV) TTE values, including tricuspid annular plane systolic excursion (TAPSE), tricuspid annular systolic velocity (TASV), right ventricular global longitudinal strain (RVGLS), and RV free-wall GLS (RVFWGLS), indicated greater RV function impairment in the thoracotomy group than in the VATS group [TAPSE(mm) 17.90 ± 3.80 vs. 21.00 ± 3.48, p = 0.006; d = 0.84; TASV(cm/s): 12.40 ± 2.90 vs. 14.70 ± 2.40, p = 0.004, d = 0.86; RVGLS(%): − 16.00 ± 4.50 vs. − 19.40 ± 2.30, p = 0.012, d = 0.20; RVFWGLS(%): − 11.50 ± 8.50 vs. − 18.31 ± 5.40, p = 0.009, d = 0.59; respectively].

Conclusions

Unlike RV function, LV function remained preserved after lung resection. The thoracotomy group exhibited greater RV function impairment than did the VATS group. Further studies should evaluate the long-term impact of surgical approach on cardiac function.

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Acknowledgements

The authors thank Payam Akhyari, Department of Cardiac Surgery, University Hospital of RWTH Aachen, Germany, for critical review of the manuscript.

Funding

This research received no external funding.

Author information

Author notes

  1. Alish Kolashov and Shahram Lotfi have contributed equally and share first authorship.

  2. Rashad Zayat and Mohammad Amen Khattab have contributed equally and share last authorship.

Authors and Affiliations

  1. Department of Cardiac Surgery, Medical Faculty and RWTH University Hospital Aachen, RWTH Aachen University, Aachen, Germany

    Alish Kolashov, Shahram Lotfi, Mohamed Shoaib, Nima Hatam & Mohammad Amen Khattab

  2. Department of Thoracic Surgery, Medical Faculty and RWTH University Hospital Aachen, RWTH Aachen University, Aachen, Germany

    Jan Spillner & Rashad Zayat

  3. Department of Cardiology, Maria-Hilf Hospital Daun, Daun, Germany

    Saif Almaghrabi

  4. Department of Cardiothoracic Surgery, Heart Center Trier, Barmherzigen Brüder Hospital Trier, Trier, Germany

    Assad Haneya & Rashad Zayat

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  1. Alish Kolashov
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Contributions

AK and SL contributed equally as first authors. RZ and MAK contributed equally as last authors. AK wrote the first version of the manuscript and drafted it. RZ JS, AH, and MAK: concept and design. RZ, SL, and NH: resources and administration. AK, SL, and MS: data collection. AK, SL, NH, MAK, and RZ performed echocardiography. AK, MAK, and SL conducted the study. AK, SL, NH, and RZ: echocardiography analysis. AK, SL, RZ, and MAK: interpretation of data. AK, SL, RZ, and MS: visualization. AK and SL: statistical analysis. JS, RZ, and MAK: supervision. AK, SL, RZ, and MAK: methodology. All authors approved the final version of the manuscript for publication. All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Rashad Zayat.

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Kolashov, A., Lotfi, S., Spillner, J. et al. Evaluation of myocardial work changes after lung resection—the significance of surgical approach: an echocardiographic comparison between VATS and thoracotomy. Gen Thorac Cardiovasc Surg (2024). https://doi.org/10.1007/s11748-023-02005-7

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