Validation Study on the Accuracy of Echocardiographic Measurements of Right Ventricular Systolic Function in Pulmonary Hypertension

Sato, Takahiro; Tsujino, Ichizo; Ohira, Hiroshi; Oyama‐Manabe, Noriko; Yamada, Asuka; Ito, Yoichi M.; Goto, Chisa; Watanabe, Taku; Sakaue, Shinji; Nishimura, Masaharu

doi:10.1016/j.echo.2011.12.012

Cited by 126 publications

(99 citation statements)

References 30 publications

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“…In our previous report, we examined the accuracy of five echocardiographic indices of RV systolic function and found that the five indices, particularly TAPSE, had acceptable accuracy in PH [8]. In the present study, we confirmed that TAPSE is strongly correlated with CMRI-derived RV EF in an expanded cohort of PH patients (n=53).…”

Section: Discussionsupporting

confidence: 73%

“…We have recently reported a close correlation between TAPSE and CMR-derived RV EF (CMR-derived RV EF = 2.03 x TAPSE -0.93) in 37 patients with PH [8]. In this study, however, we did not examine the results from a standpoint that CMR-derived RV EF can be mathematically predicted by TAPSE.…”

Section: Introductionmentioning

confidence: 38%

“…The reproducibility of the measurement of TAPSE was shown to be high by both Bland-Altman plot and ICC (≥0.90) in our previous publication [8].…”

Section: Echocardiographymentioning

confidence: 99%

“…Unlike left ventricle, myocardial fibers project longitudinally rather than 5 circumferentially in right ventricle, and TAPSE is used as a simple echocardiographic index of RV systolic function. Also, prior publications including ours have reported close correlations between TAPSE and RV EF [6][7][8][9]. However, few studies have focused on the ability of TAPSE for the mathematical prediction of RV EF.…”

Section: Introductionmentioning

confidence: 99%

“…Echocardiograms were obtained using Vivid q (GE Healthcare, Milwaukee, WI, USA) and the images were analyzed off-line after the procedure in the same manner in our previous report [8]. In short, 2-dimensional parasternal and apical views were used to obtain left ventricular (LV) and left atrial diameters.…”

Section: Echocardiographymentioning

confidence: 99%

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Simple prediction of right ventricular ejection fraction using tricuspid annular plane systolic excursion in pulmonary hypertension

Sato

Tsujino

Oyama‐Manabe

et al. 2013

Int J Cardiovasc Imaging

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Purpose: The present study examined whether tricuspid annular plane systolic excursion (TAPSE) can simply predict right ventricular ejection fraction (RVEF) in patients with pulmonary hypertension (PH). The TAPSE cut-off value to predict reduced RV EF was also evaluated. Methods and results:The association between TAPSE and cardiac magnetic resonance imaging (CMRI)-derived RVEF was examined in 53 PH patients. The accuracy of the prediction equation to calculate RVEF using TAPSE was also evaluated. In PH patients, TAPSE was strongly correlated with CMRI-derived RVEF in PH patients (r=0.86, p<0.0001). We then examined the accuracy of the two equations: the original regression equation (RVEF = 2.01 x TAPSE + 0.6) and the simplified prediction equation (RV EF = 2 x TAPSE). Bland-Altman plot showed that the mean difference ± limits of agreement was 0.0 ± 10.6 for the original equation and −0.6 ± 10.6 for the simplified equation. Intraclass correlation coefficient was 0.84 for the original and 0.82 for the simplified equation. Normal RV EF was considered to be ≥ 40% based on the data from 53 matched controls, and the best TAPSE cut-off value to determine reduced RV EF (< 40%) was calculated to be 19.7 mm (sensitivity 88.9%, specificity 84.6%). Conclusion:A simple equation of RV EF = 2 x TAPSE enables easy prediction of RV 3 EF using TAPSE, an easily measurable M-mode index of echocardiography. TAPSE of 19.7 mm predicts reduced RV EF in PH patients with clinically acceptable sensitivity and specificity.4

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Section: Discussionsupporting

confidence: 73%

Section: Introductionmentioning

confidence: 38%

“…The reproducibility of the measurement of TAPSE was shown to be high by both Bland-Altman plot and ICC (≥0.90) in our previous publication [8].…”

Section: Echocardiographymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Echocardiographymentioning

confidence: 99%

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Simple prediction of right ventricular ejection fraction using tricuspid annular plane systolic excursion in pulmonary hypertension

Sato

Tsujino

Oyama‐Manabe

et al. 2013

Int J Cardiovasc Imaging

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Pediatric Pulmonary Hypertension: Definitions, Mechanisms, Diagnosis, and Treatment

Mukherjee

Konduri

2021

Comprehensive Physiology

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The dangerous and contradictory prognostic significance of PVR<3WU when TAPSE<16mm in postcapillary pulmonary hypertension

et al. 2020

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Aims In 2019, pulmonary vascular resistance (PVR) < 3WU was adopted to stratify patients at low risk in pulmonary hypertension due to left heart disease (PH-LHD) as well those with isolated PH-LHD. We sought to evaluate whether supervised machine learning with decision tree analysis, which provides more information than Cox Proportional analysis by forming a hierarchy of multiple covariates, confirms this risk stratification. Methods and results Two hundred two consecutive patients (mean age: 69 ± 11 years, female: 42%) with mean pulmonary artery pressure ≥ 20 mmHg and wedge pressure > 15 mmHg were recruited. Transpulmonary pressure gradient ⩾̸ 12 mmHg, PVR ⩾̸ 3WU, diastolic pressure gradient ⩾̸ 7 mmHg, pulmonary arterial capacitance < 1.1 mL/mmHg, tricuspid annular plane systolic excursion (TAPSE) < 16 mm, peak systolic tissue Doppler velocity < 10 cm/s, right ventricular end-diastolic area ⩾̸ 25 cm 2 were the seven categorical values entered into the model due to their prognostic significance in PH. We used the chi-squared automatic interaction detection method to predict mortality. Each node and branch were compared using survival analysis at 6-year follow-up. Mean pulmonary artery pressure, wedge pressure, cardiac index, and PVR were 40.3 ± 10.0 mmHg, 22.3 ± 7.1 mmHg, 2.9 ± 0.8 L/min/m 2 , and 3.6 ± 2.1WU, respectively. Among the seven dichotomous, TAPSE was first selected following by PVR. Compared with patients with PVR < 3WU and TAPSE ⩾̸ 16 mm, patients with PVR ⩾̸ 3WU and TAPSE ⩾̸ 16 mm, or patients with PVR ⩾̸ 3WU and TAPSE<16 mm had significantly increased mortality, HR = 3.0, 95% CI = [1.4-6.4], P = 0.006 and HR = 3.3, 95% CI = [1.6-6.9], P = 0.002, respectively, while patients with PVR < 3WU and TAPSE < 16 mm exhibited the worst prognosis, HR = 7.2, 95% CI = [3.3-15.9], P = 0.0001. Conclusions Used for solving regression and classification problems, decision tree analysis confirms that PVR and TAPSE have to be analysed together in PH-LHD and revealed the dangerous and contradictory prognostic significance of PVR < 3WU when TAPSE<16 mm.

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Validation Study on the Accuracy of Echocardiographic Measurements of Right Ventricular Systolic Function in Pulmonary Hypertension

Cited by 126 publications

References 30 publications

Simple prediction of right ventricular ejection fraction using tricuspid annular plane systolic excursion in pulmonary hypertension

Simple prediction of right ventricular ejection fraction using tricuspid annular plane systolic excursion in pulmonary hypertension

Pediatric Pulmonary Hypertension: Definitions, Mechanisms, Diagnosis, and Treatment

The dangerous and contradictory prognostic significance of PVR<3WU when TAPSE<16mm in postcapillary pulmonary hypertension

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