Abstract 13965: Are TAPSE and S’ Reliable Measures of Right Ventricular Performance?
Introduction: According to recent recommendations, both tricuspid annular systolic excursion (TAPSE) and tissue-Doppler-derived tricuspid lateral annular systolic velocity (S’) are reliable methods for the evaluation of right ventricular (RV) systolic performance. The effects of tricuspid regurgitation (TR) on the relationship between these indices and RV function are not well recognized. We studied the relationships between TAPSE and S’ with cardiovascular magnetic resonance (CMR)-derived RV ejection fraction (EF) and the influence of TR on these relationships.
Methods: 211 patients (48±17yrs;mean RVEF 46±15%; range 9-72%), who had both CMR and 2D echocardiography (2DE) were studied. With CMR (1.5-T scanner), consecutive short axis cines spanning the RV were used to measure RVEF using the method of disks. On 2DE, TAPSE and S’ measured from pulsed-wave tissue Doppler sample volume placed in a basal segment of the RV free wall were recorded in the apical-4 chamber view. TAPSE and S’ measures were correlated to CMR RVEF.
Results: Average time between CMR and 2DE was 1.4±2 days. A moderate correlation was seen between TAPSE and RVEF (r=0.47) and S’ and RVEF (r=0.50). In patients with ≥moderate TR (n=38) the correlation between TAPSE and RVEF and S’ and RVEF was poor (r=0.00 and r=0.25, respectively). Excluding these patients, however, did not change the correlations with RVEF (r=0.45 for TAPSE; r=0.51 for S’, n=173).
Conclusions: In patients with significant TR, both TAPSE and S’ are poor indices of global RV function. Even without significant TR, the relationship was moderate, indicating these indices should not be used as sole measures of RV performance.
- © 2013 by American Heart Association, Inc.