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[Indocyanine green (TCG) clearance as a monitor to evaluate right heart function]
J Utoh1, R Kunitomo, H Sakaguchi
1First Department of Surgery, Kumamoto University School of Medicine, Japan.
Insights
The Indocyanine Green (ICG) clearance test can effectively evaluate right heart function, particularly after tricuspid annuloplasty surgery. This non-invasive test quantifies how well the heart processes the dye, offering insights into recovery and overall cardiac health.
Area of Science:
- Cardiology
- Medical Diagnostics
Background:
- Right heart failure significantly impacts systemic venous return.
- Hepatic venous return to the right atrium influences Indocyanine Green (ICG) clearance.
- Assessing right heart function is crucial for managing various cardiac conditions.
Purpose of the Study:
- To investigate the utility of the ICG clearance test in evaluating right heart function.
- To compare ICG clearance in patients with different heart valve diseases and ischemic heart disease.
- To assess the impact of tricuspid annuloplasty on right heart function as measured by ICG clearance.
Main Methods:
- Studied patients with mitral valve disease (Group M), aortic valve disease (Group A), and ischemic heart disease (Group CABG).
- Measured preoperative K-ICG values (a marker of ICG clearance) in all groups.
- Analyzed K-ICG values in patients who underwent tricuspid annuloplasty (TAP) pre- and post-operatively.
Main Results:
- Preoperative K-ICG was significantly lower in Group M compared to Groups A and CABG.
- Patients undergoing TAP within Group M showed significantly lower preoperative K-ICG than other Group M patients.
- Postoperative K-ICG significantly increased in TAP patients, indicating improved right heart function.
Conclusions:
- The ICG clearance test is a valuable tool for quantifying right heart function.
- The test is particularly useful for postoperative evaluation following cardiac procedures like TAP.
- ICG clearance can help monitor the effectiveness of interventions aimed at improving right heart function.
Abstract:
Systemic venous return to the heart is disturbed as a result of right heart failure. ICG clearance is known to be influenced by hepatic venous return to the right atrium. Under a hypothesis that right heart function could be evaluated by ICG clearance test, patients with mitral valve disease (Group M, n = 29), aortic valve disease (Group A, n = 16), ischemic heart disease (Group CABG, n = 19) were studied. Preoperative K-ICG (normal range > 0.17) in the Group M was significantly lower than those in the Group A and Group CABG (0.097 +/- 0.037 vs 0.166 +/- 0.032 and 0.171 +/- 0.027, p < 0.05). In the Group M, patients who underwent tricuspid annuloplasty (TAP) had significantly lower K-ICG than the others (0.077 +/- 0.026 vs 0.113 +/- 0.038, p < 0.05). Postoperatively, K-ICG of TAP patients significantly increased (0.092 +/- 0.031, p < 0.05) when compared to their preoperative value. ICG clearance test was useful to quantify the right heart function, especially in the postoperative evaluation.