Background: Tricuspid annular plane systolic excursion (TAPSE) is a recommended quantitative measure of right ventricular (RV) longitudinal function assessed by Mmode echocardiography. Offline alternatives are desirable when TAPSE is unavailable. This study aimed to assess the feasibility, reliability, and agreement between retrospectively obtained measures of tricuspid annular displacement using Doppler tissue imaging (TAD DTI ) and speckle tracking echocardiography (TAD STE ) compared with reference TAPSE.Methods: Consecutive subjects referred for evaluation of heart failure were enrolled.Subjects in atrial fibrillation, significant valvular disease, or with poor image quality were excluded. TAPSE was measured during the examination using M-mode. TAD STE was measured as the maximal longitudinal displacement of the RV basal segment in systole using speckle strain imaging. TAD DTI was derived offline from color-DTI superimposed grayscale images.Results: 107 subjects (age 60 ± 16; 48% female) were analyzed. Both TAD DTI and TAD STE demonstrated good feasibility and excellent intra-and inter-observer concordances. Although both measures demonstrated strong association with TAPSE, TAD DTI showcased lower specificity to identify RV dysfunction and higher false positives. Bland-Altman analysis revealed a tendency of TAD DTI to underestimate TAPSE (bias = 1.40; SD = 2.74 mm) as compared with TAD STE (bias = 0.27; SD = 2.30mm).Wide limits of agreement were observed for both methods.Conclusions: TAD STE and TAD DTI provide reproducible and feasible quantification of RV function. However, TAD DTI significantly underestimates TAPSE limiting the interchangeability of these modalities. K E Y W O R D S motion-mode echocardiography, myocardial mechanics, tricuspid annular plane systolic excursion | 2005 TAN eT Al.

Background Tricuspid annular plane systolic excursion (TAPSE) is a validated index of right ventricular function in heart failure. Current guidelines recommend that TAPSE be measured employing M-mode echocardiography (TAPSEM). However, TAPSEM is often overlooked during routine clinical assessment. This study aimed to assess the correlation and strength of agreement between other retrospectively obtainable echocardiographic equivalents of tricuspid annular displacement during systole (TAD) and TAPSEM. Methods An echocardiographic review was performed in consecutive subjects in sinus rhythm referred for the assessment of dyspnoea or heart failure. TAD was measured employing 2D (TAD2D), tissue velocity imaging (TADTVI), and speckle tracking echocardiography (TADSTE) and compared with TAPSEM as reference. Results 100 subjects were analysed (age: 61± 14; 49% Female) All methods demonstrated good feasibility. Of all the evaluated methods, TAD2D demonstrated the strongest association with TAPSEM with minimal bias and reasonable limits of agreement (Table 1). Bias between methods was further reduced in subjects with significant pulmonary hypertension (RVSP > 50mmHg (35%); Bland-Altman mean ± SD = 0.09 ± 2.0 mm). A good agreement between TADSTE and TAPSEM was as well observed. In contrast, TADTVI yielded an underestimation of TAPSEM. Conclusions TAD2D and TADSTE provide feasible and accurate alternatives to TAPSEM and maybe useful during retrospective analysis of RV longitudinal function. Feasibility, Correlation & B-A Analysis TAD Methods Feasibility R value P Value Bland-Altman mean difference ± SD TAD2D 92% 0.94 <0.001 0.22 ± 1.87 mm TADTVI 88% 0.86 <0.001 1.59 ± 3.1 mm TADSTE 85% 0.87 <0.001 0.47 ± 2.7 mm TAD, Tricuspid annular displacement; 2D, Two dimensional; TVI, tissue velocity imaging; STE, speckle tracking echocardiography