Tricuspid Annular Displacement Predicts Survival in Pulmonary Hypertension

Forfia, Paul R.; Fisher, Micah R.; Mathai, Stephen C.; Housten-Harris, Traci; Hemnes, Anna R.; Borlaug, Barry A.; Chamera, Elzbieta; Corretti, Mary C.; Champion, Hunter C.; Abraham, Theodore P.; Girgis, Reda E.; Hassoun, Paul M.

doi:10.1164/rccm.200604-547oc

Cited by 955 publications

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“…These results were supported by comparable results for cardiovascular mortality in addition to correlations between RVEF and previously reported robust predictors of outcome in PAH, including cardiac index, right atrial pressure, TAPSE, NT-proBNP and SvO 2 [4,[20][21][22]. Collectively, these observations suggest measurement of RVEF may be a useful tool to evaluate the long-term prognosis of patients with PAH.…”

Section: Discussionsupporting

confidence: 84%

“…Other baseline variables relating to the RV function have previously been associated with overall survival in patients with PAH. Echocardiographic measurement of TAPSE at baseline predicted survival in a heterogeneous population of patients with precapillary PH (only one-third of whom had idiopathic PAH) [21]. Similarly, RVEF assessed with cardiac MRI independently predicted long-term outcome in patients with PAH [22].…”

Section: Discussionmentioning

confidence: 99%

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Prognostic value of right ventricular ejection fraction in pulmonary arterial hypertension

et al. 2014

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Right ventricle ejection fraction (RVEF) evaluated with magnetic resonance imaging is a strong determinant of patient outcomes in pulmonary arterial hypertension. We evaluated the prognostic value of RVEF assessed with conventional planar equilibrium radionuclide angiography at baseline and change 3-6 months after initiating pulmonary arterial hypertension-specific therapy.In a prospective cohort of newly diagnosed patients with idiopathic, heritable or anorexigen-associated pulmonary arterial hypertension, RVEF was measured at baseline (n=100) and 3-6 months after initiation of therapy (n=78). After a median follow-up of 4.1 years, 41 deaths occurred, including 35 from cardiovascular causes. Patients with a (median) baseline RVEF >25% had better survival than those with a RVEF <25% using Kaplan-Meier analysis ( p=0.010). RVEF at baseline was an independent predictor of all-cause and cardiovascular mortality in adjusted Cox regression model ( p=0.002 and p=0.007, respectively; HR 0.93 for both). Patients with stable or increased RVEF at 3-6 months had a trend for improved all-cause survival (HR 2.43, p=0.086) and had less cardiovascular mortality (HR 3.25, p=0.034) than those in whom RVEF decreased despite therapy.RVEF assessed with conventional planar equilibrium radionuclide angiography at baseline and change in RVEF 3-6 months after therapy initiation independently predict outcomes in patients with pulmonary arterial hypertension. @ERSpublications RVEF assessed with CPERA at baseline, and its changes on therapy, independently predict outcome in patients with PAH http://ow.ly/DsCS4

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Prognostic value of right ventricular ejection fraction in pulmonary arterial hypertension

et al. 2014

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“…4 A TAPSE of \ 1.8 cm predicted a SVI of \ 29 mLÁm -2 . 1 We found a modest correlation between TAPSE by M mode and SV (r = 0.48).…”

Section: Discussionmentioning

confidence: 59%

“…Indeed, RV dysfunction assessed using RV ejection fraction (RVEF), RV stroke work, RV fractional area of change, or tricuspid annular systolic plane excursion (TAPSE) is a predictor of outcome in cardiac surgery, transplantation, and patients with pulmonary hypertension. [1][2][3] Due to its simplicity and ease of application, TAPSE has become a commonly measured variable in the assessment of RV function, however, it remains one dimensional. Tricuspid annular systolic plane excursion is commonly measured using M mode, but it can be measured using speckle tracking (tracking of B mode markers) or tissue tracking (TT) [integrating annular velocity (S') measured by colour tissue Doppler].…”

Section: Résumémentioning

confidence: 99%

Evaluation of TAPSE as a measure of right ventricular output

Tousignant

Kim

Papa

et al. 2012

Can J Anesth/J Can Anesth

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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

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“…[36][37][38][39] RV longitudinal shortening (tricuspid annular plane excursion [TAPSE]) and transverse shortening provide clinical relevant measures that are correlated with global RV function. 22,40,41 Although the determination of global measures of RV function is relative time consuming, these measures are simpler to obtain. Mauritz et al 22 showed that both transverse and longitudinal shortening were valuable parameters and that, in particular, a progressive decrease in RV transverse wall motion is associated with end-stage RV disease.…”

Section: Regional Rv Function and Strainmentioning

confidence: 99%

State of the Art: Advanced Imaging of the Right Ventricle and Pulmonary Circulation in Humans (2013 Grover Conference Series)

et al. 2014

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Pulmonary arterial hypertension (PAH) is a progressive disease characterized by remodeling and vasoconstriction of the pulmonary vasculature, ultimately leading to right ventricular (RV) failure and death. Recent developments in echocardiography, cardiovascular magnetic resonance imaging, computed tomography, and positron emission tomography allow advanced, noninvasive, in vivo assessment of the RV and have contributed to the identification of risk factors, prognostic factors, and monitoring of therapeutic responses in patients with PAH. Although far from reaching its future potential, these techniques have not only provided global RV assessment but also allowed evaluation of changes in cellular and molecular tissue processes, such as metabolism, oxygen balance and ischemia, angiogenesis, and apoptosis. Integrated application of these techniques could provide full insights into the different pathophysiological aspects of a failing RV in the setting of PAH. Recent advances in hybrid imaging have implemented simultaneous measurements of myocardial and vascular interactions and will be one of the most important potential future developments.

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Tricuspid Annular Displacement Predicts Survival in Pulmonary Hypertension

Abstract: TAPSE powerfully reflects RV function and prognosis in PAH.

Cited by 955 publications

References 28 publications

Prognostic value of right ventricular ejection fraction in pulmonary arterial hypertension

Prognostic value of right ventricular ejection fraction in pulmonary arterial hypertension

Evaluation of TAPSE as a measure of right ventricular output

State of the Art: Advanced Imaging of the Right Ventricle and Pulmonary Circulation in Humans (2013 Grover Conference Series)

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