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Updated: Jan 25, 2026

Transthoracic Echocardiography in Mice
08:09

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Application of transthoracic echocardiography in patients receiving intermediate- or high-risk noncardiac surgery

Hsien-Yuan Chang1,2, Wei-Ting Chang3,4, Yen-Wen Liu1,2

  • 1Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

Plos One
|April 26, 2019
PubMed

Insights

Preoperative echocardiography, including mitral regurgitation assessment, improves risk prediction for major adverse events after noncardiac surgery. This helps identify high-risk patients for better perioperative care.

Area of Science:

  • Cardiology
  • Anesthesiology
  • Cardiac Surgery

Background:

  • Cardiovascular events are a primary cause of perioperative complications in noncardiac surgery.
  • The utility of echocardiography for preoperative cardiac risk stratification remains debated.

Purpose of the Study:

  • To evaluate the role of preoperative transthoracic echocardiography (TTE) in risk stratification for major adverse events (MAEs) after noncardiac surgery.
  • To compare the predictive value of TTE findings with the modified Lee index for MAEs.

Main Methods:

  • Retrospective study of 1453 patients undergoing intermediate- or high-risk noncardiac surgery.
  • Preoperative transthoracic echocardiography (TTE) performed on all patients.
  • Follow-up for 56 days post-surgery, monitoring all-cause mortality and major adverse cardiovascular-cerebral events (MACCEs).

Main Results:

  • 35 patients (2.4%) experienced primary endpoints (mortality or MACCEs).
  • Higher E/e' values, lower left ventricular ejection fraction, and significant mitral regurgitation (MR) were associated with postsurgery MAEs.
  • Multivariate analysis identified modified Lee index and significant MR as independent predictors of MAEs.

Conclusions:

  • Preoperative identification of significant mitral regurgitation (MR) via TTE improves MAE prediction beyond the modified Lee index in high-risk noncardiac surgery patients.
  • TTE provides valuable prognostic information for perioperative risk assessment.
Abstract

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