Agreement Between FAC and TAPSE as Markers of Right Ventricular Function in Adult Patients Undergoing Cardiac Surgery at The Hospital Cardiovascular Del Niño De Cundinamarca

Introduction: Right ventricular dysfunction represents a diagnostic challenge, particularly in the absence of invasive monitoring using a pulmonary artery catheter (Swan-Ganz).In this setting, echocardiography is considered the noninvasive method of choice for the assessment of right ventricular function, making it necessary to standardize the most reliable echocardiographic parameter in the postoperative period of cardiac surgery.Objective: To evaluate the agreement between fractional area change (FAC) and tricuspid annular plane systolic excursion (TAPSE) measurements as echocardiographic markers of right ventricular function in the postoperative period of adult patients undergoing cardiac surgery.Methods: A Descriptive agreement study was conducted including 22 patients older than 18 years who underwent cardiac surgery at the Hospital Cardiovascular del Niño de Cundinamarca.Agreement between fractional area change (FAC) and tricuspid annular plane systolic excursion (TAPSE) was evaluated, and their correlation with the central venous pressure/pulmonary artery occlusion pressure index (CVP/ PAOP), measured by thermodilution, was analyzed.Results: Of the study population, 63.5% (n = 14) presented postoperative right ventricular dysfunction, defined by a CVP/PAOP ratio < 0.8.Likewise, 68.2% (n = 15) showed right ventricular dysfunction assessed by TAPSE < 1.7 cm, and 59.1% (n = 13) by FAC < 32%.When analyzing agreement, the kappa index between the CVP/PAOP ratio and TAPSE was -0.31 (p = 0.97), while that between CVP/PAOP and FAC was -0.43 (p = 0.92).In contrast, agreement between TAPSE and FAC showed a kappa index of 0.41 (p = 0.02).Conclusion: Echocardiographic evaluation of the right ventricle (RV) allows the diagnosis of right ventricular dysfunction, demonstrating good agreement between its two main parameters, TAPSE and FAC.However, these measurements do not replace the hemodynamic information obtained using a Swan-Ganz catheter, which is considered the gold standard in the absence of cardiac magnetic resonance imaging.