{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T13:21:24Z","timestamp":1788182484043,"version":"build-2803163510"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Chronic nasal septum deviation (NSD) may cause persistent upper airway obstruction, intermittent hypoxia, and sympathetic overactivity, potentially leading to subtle alterations in right ventricular (RV) structure and function. Advanced echocardiographic techniques \u2013 including three-dimensional RV ejection fraction (3D-RVEF), myocardial performance index (Tei index), and RV longitudinal strain \u2013 enable detection of subclinical RV dysfunction associated with chronic hypoxic states and sleep-disordered breathing. Relief of airway obstruction may be associated with changes in cardiopulmonary physiology that could influence RV functional parameters. This study aimed to evaluate changes in RV mechanics following septoplasty using comprehensive conventional and advanced echocardiographic assessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This prospective observational study included 30 consecutive adults undergoing elective septoplasty for symptomatic NSD. Comprehensive transthoracic echocardiography was performed preoperatively and 3 months postoperatively. Conventional RV functional parameters \u2013 tricuspid annular plane systolic excursion (TAPSE), RV fractional area change (FAC), and pulmonary artery systolic pressure (PASP) \u2013 were measured together with advanced indices obtained from 3D echocardiography (3DE) and speckle-tracking analysis, including 3D-RVEF, RV myocardial performance index (Tei index), and RV free-wall longitudinal strain (FWLS). Paired statistical comparisons were conducted to assess postoperative changes in accordance with contemporary echocardiographic quantification standards.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Septoplasty was associated with significant improvement in both conventional and advanced RV functional parameters. TAPSE increased from 21.6 \u00b1 2.7 mm to 23.4 \u00b1 3.1 mm (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.002), RV FAC increased from 43% \u00b1 6% to 47% \u00b1 7% (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.008), and PASP decreased from 30 \u00b1 6 mmHg to 25 \u00b1 5 mmHg (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.001). Advanced echocardiographic analysis demonstrated a significant rise in 3D-RVEF (48% \u00b1 5% to 53% \u00b1 6%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), a reduction in Tei index (0.46 \u00b1 0.08\u20130.38 \u00b1 0.07,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.002), and improvement in RV FWLS (\u221219.8% \u00b1 3.2% to \u221223.1% \u00b1 3.6%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). Left ventricular systolic function remained unchanged, and no perioperative cardiovascular complications occurred.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Septoplasty is associated with measurable improvement in RV mechanics assessed by 3DE, myocardial performance index, and strain imaging. Relief of chronic upper airway obstruction may therefore contribute to favorable subclinical cardiopulmonary remodeling beyond symptomatic nasal improvement. These findings highlight the value of advanced echocardiographic assessment in detecting reversible RV dysfunction and warrant confirmation in larger controlled prospective studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jcecho.jcecho_30_26","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T09:00:34Z","timestamp":1788166834000},"page":"446-452","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Septoplasty on Right Ventricular Mechanics Assessed by Three-dimensional Echocardiography, Myocardial Performance Index, and Strain Analysis"],"prefix":"10.4103","volume":"36","author":[{"given":"Cem","family":"Korucu","sequence":"first","affiliation":[{"name":"Department of Cardiology, Suru\u00e7 State Hospital, \u015eanl\u0131urfa, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arif","family":"Y\u0131lmaz","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery, Afyonkarahisar Health Sciences University Faculty of Medicine, Afyonkarahisar, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,8,30]]},"reference":[{"key":"R1-20260831","doi-asserted-by":"crossref","first-page":"1080","DOI":"10.1161\/CIRCULATIONAHA.107.189420","article-title":"Sleep apnea and cardiovascular disease: An American Heart Association\/American College of Cardiology Foundation Scientific Statement","volume":"118","author":"Somers","year":"2008","journal-title":"Circulation"},{"key":"R2-20260831","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1016\/j.jacc.2016.11.069","article-title":"Sleep apnea: Types, mechanisms, and clinical cardiovascular 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echocardiography: Benefits and limitations of integrating myocardial mechanics with three-dimensional imaging","volume":"8","author":"Muraru","year":"2018","journal-title":"Cardiovasc Diagn Ther"},{"key":"R8-20260831","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1161\/CIRCIMAGING.113.000640","article-title":"Outcome prediction by quantitative right ventricular function assessment in 575 subjects evaluated for pulmonary hypertension","volume":"6","author":"Fine","year":"2013","journal-title":"Circ Cardiovasc Imaging"},{"key":"R9-20260831","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1093\/eurheartj\/ehv317","article-title":"2015 ESC\/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT)","volume":"37","author":"Gali\u00e8","year":"2016","journal-title":"Eur Heart J"},{"key":"R10-20260831","doi-asserted-by":"crossref","first-page":"3747","DOI":"10.1007\/s00405-016-4042-1","article-title":"The effect of septoplasty on pulmonary artery pressure and right ventricular function in nasal septum deviation","volume":"273","author":"Ozkececi","year":"2016","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"R11-20260831","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1097\/SCS.0000000000007801","article-title":"The impact of septoplasty on cardiopulmonary functions in patients with nasal septal deviation: A prospective comprehensive analysis of echocardiographic outcome and serum N-terminal pro BNP levels","volume":"33","author":"Yigit","year":"2022","journal-title":"J Craniofac Surg"},{"key":"R12-20260831","first-page":"135","article-title":"New non-invasive index for combined systolic and diastolic 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