Feasibility and accuracy of tricuspid annular displacement assessed by speckle tracking echocardiography and Doppler tissue imaging

Abstract

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.

Preload Dependency of 2D Right Ventricle Speckle Tracking Echocardiography Parameters in Healthy Volunteers: A Prospective Pilot Study

“…In our study, median TAD lat was 22.7 (20.5–25) mm and 15.2 (13.7–17.3) mm for TAD sep . Those values are consistent with prior studies in healthy volunteers [ 4 , 8 , 19 ]. Indeed, in a healthy teenager population, mean values of TAD were 20.7 mm ± 3.7 for TAD lat and 14 ± 1.9 for TAD sep [ 20 ].…”

“…TAPSE is a single-dimensional, reproducible, and easily obtainable method for the assessment of RV function, which is routinely performed in clinical practice. It measures the maximal distance of systolic excursion of a single RV annular segment along its longitudinal plane [ 19 ]. TAPSE is an angle-dependent parameter, and guidelines suggest that TAPSE may be preload dependent [ 5 ].…”

“…To our knowledge, our study is the first to show that TAD parameters were preload-independent in healthy volunteers. Even if the measurements of TAPSE and TAD parameters are both based on the displacement of the tricuspid annulus, they are not interchangeable [ 19 ]. TAPSE measurement assesses excursion of the tricuspid annulus, while TAD lat measurement evaluates its shortening toward the RV apex.…”

Prophylactic Ligature of AV Fistula Prevents High Output Heart Failure after Kidney Transplantation

“…During post-study observation, all 12 intervention group patients (1 death and 1 lost to follow-up) remained stable in cardiac and renal function (up to 88 months of routine post-transplantation follow-up). In the intervention group, 7 of 8 patients with available data (i.e., echo within 3 months post-OP) had better or constant systolic PAP levels (87.5%), 1 patient had an increase in pulmonal artery pressure ( p = 0.115), and 6 of 7 patients (85.7%) showed an improved TAPSE as parameter for right heart function [22] within 3 months after ligature. Along with these echocardiographic findings, all patients reported better performance status, resolving shortness of breath and easing in daily routine activities after fistula ligature.…”