Cardiac function changes with switching from the supine to prone position: analysis by quantitative semiconductor...

Area of Science:

• Cardiology
• Cardiac Physiology
• Surgical Anesthesia

Background:

• Prone positioning is essential for procedures like spinal surgery.
• Previous research explored cardiac function changes in the prone position.
• Limited studies examined left ventricular diastolic function and rhythm shifts during prone positioning.

Purpose of the Study:

• To investigate the impact of prone positioning on left ventricular systolic and diastolic function.
• To assess changes in cardiac rhythm and synchrony in the prone position.
• To compare these effects across patient groups with varying cardiac health.

Main Methods:

• Evaluated cardiac function in 90 patients without atrial fibrillation using (99m)Tc-tetrofosmin quantitative gated single-photon emission computed tomography.
• Compared cardiac function in supine versus prone positions.
• Classified patients into three groups based on history of myocardial ischemia or cardiomyopathy.

Main Results:

• Prone positioning worsened cardiac index and increased dyssynchrony in all patient groups.
• Ejection fraction changes were observed only in patients with a history of myocardial infarction (Group B).
• Diastolic function changes occurred in patients with myocardial infarction (Group B) and ischemic heart disease (Group C), but not in Group A.

Conclusions:

• Prone positioning significantly alters systolic and diastolic cardiac function and induces dyssynchrony.
• The detrimental effects of the prone position are more pronounced in patients with compromised baseline cardiac function.