Evaluation of TAPSE as a measure of right ventricular output

Abstract

Purpose This study was designed to show the relationship between tricuspid annular plane systolic excursion (TAPSE) and stroke volume (SV) by thermodilution using three different methods and also to assess whether TAPSE can track hemodynamic changes associated with volume loading and ephedrine administration. Methods This was an observational study in 61 elective patients with a pulmonary artery catheter who were undergoing coronary artery bypass graft surgery in a cardiac surgical centre. We measured TAPSE by three methods using transesophageal echocardiography: M mode, speckle tracking at the lateral wall, and tissue tracking at the inferior wall. There were two interventions: leg raising (volume recruitment) or administration of ephedrine 5 mg iv. Echo and hemodynamic measurements were performed before and after each intervention.Results Eleven patients were excluded due to poor imaging. There were 26 patients in the leg raising group and 24 patients in the ephedrine group. The correlation coefficient between stroke volume (SV) and TAPSE by M mode, speckle tracking, and tissue tracking was 0.48, 0.44, and 0.09, respectively. There was a significant increase in SV following each intervention; however, the changes in TAPSE by any method and velocity were not large enough to reach statistical significance. Conclusion Tricuspid annular plane systolic excursion by M mode and by speckle tracking correlates modestly with SV. There was no correlation between TAPSE and SV by tissue tracking at the inferior wall of the right ventricle. Tricuspid annular plane systolic excursion by M mode and by speckle tracking does not track changes in SV following either volume loading or ephedrine administration. RésuméObjectif Cette e´tude a e´te´conçue pour montrer le rapport entre le de´placement systolique du plan de l'anneau tricuspidien (TAPSE) avec le volume d'e´jection systolique (SV) par thermodilution en utilisant trois me´thodes diffe´rentes et aussi pour de´terminer si le TAPSE peut suivre les modifications he´modynamiques associe´es a`une charge volumique et a`une administration d'e´phe´drine. Méthodes Il s'agit d'une e´tude observationnelle mene´e chez 61 patients se´lectionne´s porteurs d'un cathe´ter de l'arte`re pulmonaire qui devaient subir un pontage coronarien dans un centre de chirurgie cardiaque. Nous avons mesure´le TAPSE par trois me´thodes diffe´rentes al 'aide d'une e´chocardiographie transoesophagienne: mode M;suivi de granularite´s (speckle tracking) sur la paroi late´rale; et suivi de tissu (tissue tracking) sur la paroi infe´rieure. Il y a eu deux interventions: jambes releve´es

Alternation of Right Ventricular Contraction Pattern in Healthy Children

“…12, 13 Although some investigators have reported that TAPSE significantly correlates with RVEF and contributes to approximately 80% of RV output, others have reported that TAPSE was affected by LV function and also by pulmonary condition -resulting in a lower correlation with RVEF. 14- 18 We therefore hypothesized that RVSV was generated by longitudinal and radial RV contraction with changes of myocardial fiber structure and contraction pattern. Despite the strong linear correlation of RVSV with BSA, RVSV did not linearly correlate with increasing TAPSE.…”

Management issues during HeartWare left ventricular assist device implantation and the role of transesophageal echocardiography

“…Measuring TAPSE, because of cursor alignment difficulty, is not always reliable using intra-operative TEE. [61] LV function Evaluation of LV function prior to LVAD insertion usually reveals a ventricle with severely impaired systolic function, often associated with a significant diastolic dysfunction. [62][63][64] Severe LV dysfunction increases the risk of apical thrombus formation.…”

Validity of the Surface Electrocardiogram Criteria for Right Ventricular Hypertrophy

“…RV structure and function are difficult to assess with standard transthoracic echocardiography, and while newer research techniques, such as 3-dimensional echo 12,30–35 and speckle tracking 36–43 overcome some of these limitations, cardiac magnetic resonance imaging (cMRI) accurately measures RV mass without requiring any assumptions about RV morphology. We have previously established normative allometric equations to define RVH as RV mass > 95%ile based on demographics and body size in a normal population, which is generally mild.…”