[Assessment of cardiac function by TEE]

Area of Science:

• Cardiology
• Echocardiography
• Cardiac Physiology

Context:

• Transesophageal echocardiography (TEE) is crucial for evaluating cardiac function in surgical patients.
• Left ventricular (LV) function encompasses systolic function, diastolic function, preload, and afterload.
• Accurate assessment requires understanding the properties and load dependency of various echocardiographic parameters.

Purpose:

• To review methods for assessing LV systolic and diastolic function using TEE.
• To highlight parameters less sensitive to loading conditions, such as mitral annular velocity and Vp.
• To discuss load-independent indices like LV dP/dt and Tei index for comprehensive RV and LV function assessment.

Summary:

• Ejection fraction (EF) is a common systolic function measure.
• Transmitral flow (TMF) and pulmonary vein flow assess diastolic function.
• Mitral annular velocity, Vp, LV dP/dt, and Tei index offer load-independent assessments.
• Real-time 3D TEE provides objective data on LV volumetry, wall motion, dyssynchrony, and valvular pathology.

Impact:

• Improved understanding of TEE applications in cardiac and non-cardiac surgery.
• Guidance on selecting appropriate echocardiographic parameters for accurate cardiac function assessment.
• Highlights the utility of advanced TEE techniques and 3D imaging for objective evaluation.