Yoshihisa Morita1, Koichi Nomoto2, Gregory W Fischer1. 1. Department of Anesthesiology, Icahn School of Medicine at Mount Sinai, New York, NY. 2. Department of Anesthesiology, Icahn School of Medicine at Mount Sinai, New York, NY. Electronic address: koichi.nomoto@mountsinai.org.
Abstract
OBJECTIVES: The authors defined a modified tricuspid annular plane systolic excursion (m-TAPSE) measurement using the transesophageal echocardiography (TEE) midesophogeal 4-chamber view and investigated its clinical validity in comparison with other indices of heart function. DESIGN: Retrospective medical record review. SETTING: A single tertiary care medical center. PARTICIPANTS: One hundred ninety-six patients who underwent successful mitral valve repair. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Patients were divided into 2 groups using a proposed guideline cutoff of 16 mm of m-TAPSE. m-TAPSE was measured by apical systolic/diastolic shortening as shown in the TEE midesophogeal 4-chamber view. Right ventricular fractional area change (RV FAC) was measured by using planimetry in the same view. Correlation analysis was performed for m-TAPSE and RV FAC. One hundred six (54.1%) patients showed m-TAPSE>16 mm and 90 patients (45.9%) showed m-TAPSE<16 mm. There were no significant differences in patient demographics and comorbidities between the 2 groups except for atrial fibrillation (7.5% in m-TAPSE>16 mm v 24.4% in m-TAPSE<16 mm, p<0.001). Compared to the m-TAPSE>16 mm group, the m-TAPSE<16 mm group demonstrated significantly lower RV FAC (38.0±10.4 v 26.4±8.1, p<0.001). The correlation coefficient between m-TAPSE and RV FAC was 0.618, p< 0.001. CONCLUSIONS: m-TAPSE validated a good correlation to right ventricular systolic function as reflected by RV FAC. m-TAPSE should be considered as an easily measurable parameter to evaluate right ventricular systolic function.
OBJECTIVES: The authors defined a modified tricuspid annular plane systolic excursion (m-TAPSE) measurement using the transesophageal echocardiography (TEE) midesophogeal 4-chamber view and investigated its clinical validity in comparison with other indices of heart function. DESIGN: Retrospective medical record review. SETTING: A single tertiary care medical center. PARTICIPANTS: One hundred ninety-six patients who underwent successful mitral valve repair. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS:Patients were divided into 2 groups using a proposed guideline cutoff of 16 mm of m-TAPSE. m-TAPSE was measured by apical systolic/diastolic shortening as shown in the TEE midesophogeal 4-chamber view. Right ventricular fractional area change (RV FAC) was measured by using planimetry in the same view. Correlation analysis was performed for m-TAPSE and RV FAC. One hundred six (54.1%) patients showed m-TAPSE>16 mm and 90 patients (45.9%) showed m-TAPSE<16 mm. There were no significant differences in patient demographics and comorbidities between the 2 groups except for atrial fibrillation (7.5% in m-TAPSE>16 mm v 24.4% in m-TAPSE<16 mm, p<0.001). Compared to the m-TAPSE>16 mm group, the m-TAPSE<16 mm group demonstrated significantly lower RV FAC (38.0±10.4 v 26.4±8.1, p<0.001). The correlation coefficient between m-TAPSE and RV FAC was 0.618, p< 0.001. CONCLUSIONS: m-TAPSE validated a good correlation to right ventricular systolic function as reflected by RV FAC. m-TAPSE should be considered as an easily measurable parameter to evaluate right ventricular systolic function.
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