Abstract 14429: Tricuspid Annular Plane Systolic Excursion Is Volume Dependent
Introduction: Tricuspid annular plane systolic excursion (TAPSE) is an important echocardiographic index of right ventricular (RV) function. Its correlation with RV ejection fraction (EF) has been demonstrated, but its dependence on RV volume has not been explored. We used cardiovascular magnetic resonance (CMR) imaging to explore the relationship of TAPSE, RVEF, and RV end_diastolic volume (EDV) indexed to body surface area (BSA).
Methods: We retrospectively examined 380 clinical CMRs from 2011-2015 performed by a single reader with careful segmentation of the short axis cine stack for RV function and RVEDV. We excluded patients due to poor visualization of the tricuspid annulus and off axis views of the 4 chamber, or having had cardiac surgery, which is known to reduce TAPSE. TAPSE was measured as the difference of the perpendicular distance traveled by the tricuspid annulus to the RV apex during diastole and systole using AquariusNet Viewer (Fig 1A and 1B).
Results: We measured TAPSE in 188 patients (91 female; aged 48.4 ± 16 years) with high quality 4 chamber cine scans. The mean values of TAPSE, RVEF and RVEDVI were 2.32 ± 0.48 cm, 51± 11.1% and 90.4 ± 23.9 ml/m2, respectively. TAPSE was graphed against RVEF for three groups of RV size (RVEDVI < 100 ml/m2, 100-120 ml/m2, > 120ml/ m2), as seen in Fig 1C. TAPSE was also graphed against RVEDVI for subjects with normal (≥ 47%) and low (< 47%) RVEF, shown in Fig 1D. As expected, TAPSE correlated well across RV volume categories and patients with normal RVEF consistently maintained higher TAPSE than those with low RVEF. However, TAPSE is volume dependent as shown in the two groups with elevated EDVI have higher TAPSE at the same RVEF range (Fig1C). Additionally, patients had higher TAPSE at higher RVEDVI values despite low RVEF (Fig 1D).
Conclusions: TAPSE is not only directly correlated to RVEF, but is also dependent on RVEDVI. Interpretation of TAPSE for RV function has to take RV volume into account.
Author Disclosures: J. Pickle: None. J. Wang: None. Y. Han: Research Grant; Significant; GE, Gilead. Other Research Support; Significant; Bayer.
- © 2016 by American Heart Association, Inc.