Subcostal TAPSE: a retrospective analysis of a novel right ventricle function assessment method from the subcostal position in patients with sepsis

Main, Alison B.; Braham, Rachel; Campbell, Daniel; Inglis, Andrew J.; McLean, Anthony S.; Orde, Sam

doi:10.1186/s13089-019-0134-7

Cited by 9 publications

(6 citation statements)

References 39 publications

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“…Since TAPSE could be measured only subcostal with the HHUD we also measured it subcostal with the CUD and this value is probably different from the standard one. On the other hand, subcostal TAPSE has been found to correlate well with standard TAPSE measurements, with a mean difference of only 1.2 mm between techniques (sensitivity 97.5%) 26 …”

Section: Discussionmentioning

confidence: 92%

Performance of handheld ultrasound devices in diagnosis of pulmonary hypertension and right heart dysfunction in ICU patients

Dayıoğlu,

Gürsel,

Özercan

et al. 2023

Echocardiography

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AimThe use of handheld ultrasonography devices (HHUD) has increased recently but there are limited data about their performance in the evaluation of right heart dysfunction (RHD) and pulmonary hypertension (PHT). The aim of the study is to compare the performance of a HHUD with a conventional ultrasound device (CUD) in assessing PHT and RHD.MethodsThis single‐center prospective study was performed in a seven‐bed teaching hospital intensive care unit (ICU). PHT and RHD criteria were compared by HHUD and CUD. Additional PHT criteria and right ventricle (RV) systolic and diastolic dysfunction criteria were also measured.ResultsForty‐six patients were included in the study. There was no significant difference between the imaging rates and mean values of the parameters measured by both devices. When the positivity rates for additional PHT parameters and RHD criteria were compared, there were no significant differences between the devices. In Bland‐Altman's analysis, there was good agreement and there was no bias between the measurements of the two devices but left ventricular end‐systolic eccentricity index (LVSEI), right atrium area (RAA), and pulmonary artery diameter (PAD). Ninety percent of the patients had PHT probability, of whom 43% had a low, 37% had intermediate and 10% had a high probability of PHT. Ninety‐two percent of the patients had RHD and there was no significant difference between the devices in the diagnosis of RHD (p = .212). When RV systolic and diastolic dysfunction evaluations of the devices were compared according to the British Society of Echocardiography (BSE) criteria there was no significant difference between the devices’ measurements in the evaluation of systolic and diastolic function.ConclusionThe imaging and measurement capabilities of the HHUDs for PHT and RHD parameters were similar to CUDs, and considering the inconsistent parameters, the HHUD can be useful in diagnosing these problems.

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Section: Discussionmentioning

confidence: 92%

Performance of handheld ultrasound devices in diagnosis of pulmonary hypertension and right heart dysfunction in ICU patients

Dayıoğlu,

Gürsel,

Özercan

et al. 2023

Echocardiography

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“…Alternatively, one can identify and mark the tricuspid annulus in systole and diastole and measure the distance between the two points, which has been shown to correlate well with traditional TAPSE measurements performed from the apical window ( Fig. 3 B ) (27).…”

Section: Inadequate Parasternal and Apical Windowsmentioning

confidence: 87%

Point-of-Care Echocardiography in the Difficult-to-Image Patient in the ICU: A Narrative Review

Grotberg,

McDonald,

2024

Critical Care Explorations

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OBJECTIVES: The objective of this narrative review was to address common obstacles encountered in the ICU to acquiring quality and interpretable images using point-of-care echocardiography. DATA SOURCES: Detailed searches were performed using PubMed and Ovid Medline using medical subject headings and keywords on topics related to patient positioning, IV echo contrast, alternative subcostal views, right ventricular outflow tract (RVOT) hemodynamics, and point-of-care transesophageal echocardiography. Articles known to the authors were also selected based on expert opinion. STUDY SELECTION: Articles specific to patient positioning, IV echo contrast, alternative subcostal views, RVOT hemodynamics, and point-of-care transesophageal echocardiography were considered. DATA EXTRACTION: One author screened titles and extracted relevant data while two separate authors independently reviewed selected articles. DATA SYNTHESIS: Impediments to acquiring quality and interpretable images in critically ill patients are common. Notably, body habitus, intra-abdominal hypertension, dressings or drainage tubes, postoperative sternotomies, invasive mechanical ventilation, and the presence of subcutaneous emphysema or lung hyperinflation are commonly encountered obstacles in transthoracic image acquisition in the ICU. Despite these obstacles, the bedside clinician may use obstacle-specific maneuvers to enhance image acquisition. These may include altering patient positioning, respiratory cycle timing, expanding the subcostal window to include multilevel short-axis views for use in the assessment of RV systolic function and hemodynamics, coronal transhepatic view of the inferior vena cava, and finally point-of-care transesophageal echocardiography. CONCLUSIONS: Despite common obstacles to point-of-care echocardiography in critically ill patients, the beside sonographer may take an obstacle-specific stepwise approach to enhance image acquisition in difficult-to-image patients.

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“…The estimation of tricuspid annular movement in the subcostal view is getting more attention. "Subcostal TAPSE" has been assessed with anatomical M-mode and B-mode in adult and pediatric populations and proved to be a feasible and accurate alternative to conventional TAPSE with adequate efficacy in the identification of RV dysfunction [18][19][20]. Nevertheless, it has never been investigated in PE diagnostics and prognosis.…”

Section: Discussionmentioning

confidence: 99%

Subcostal echocardiographic assessment of tricuspid annular kick (SEATAK): A novel independent predictor of 30-day mortality in patients with acute pulmonary embolism

Wiliński¹,

Skwarek²,

Borek³

et al. 2022

Kardiol Pol

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Background:The most commonly used parameter of right ventricular (RV) systolic function -tricuspid annular plane systolic excursion (TAPSE) -is unavailable for some patients. Subcostal echocardiographic assessment of tricuspid annular kick (SEATAK) has been proposed as its alternative. Aim:The study aimed to assess the feasibility of SEATAK use in patients with acute pulmonary embolism (PE) and its value in prognosis after PE. Methods:The observational study included 164 consecutive patients (45.7% men; average age, 70 years) with a high clinical probability of PE referred for computed tomography pulmonary angiography.Results: SEATAK was unavailable due to inadequate quality of echocardiogram in 2.8% of patients, whereas TAPSE could not be calculated in 4.9%, both parameters were not estimated only in 0.6%. SEATAK and TAPSE values did not differ between groups of patients with PE (n = 82) and without (n = 82). In the whole study, SEATAK correlated positively with TAPSE (r = 0.71; 95% confidence interval [CI], 0.62-0.78; P <0.001), fractional area change of the RV, left ventricular ejection fraction, and peak systolic tricuspid annular velocity assessed with tissue Doppler imaging. There were only 3 echocardiographic predictors of 30-day all-cause mortality in patients with with PE (n = 10): SEATAK, pulmonary acceleration time, and the 60/60 sign. SEATAK predicted 30-day all-cause mortality with AUC (area under the curve) 0.726 (95% CI, 0.594-0.858; P = 0.01) and 30-day PE-related mortality (n = 4) with AUC, 0.772 (95% CI, 0.506-0.998; P = 0.03).Conclusions: SEATAK is a promising practicable echocardiographic parameter reflecting RV systolic function and might be an accurate alternative to TAPSE. Moreover, SEATAK could be an independent predictor of all-cause and PE-related 30-day mortality in patients with acute PE.

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Subcostal TAPSE: a retrospective analysis of a novel right ventricle function assessment method from the subcostal position in patients with sepsis

Cited by 9 publications

References 39 publications

Performance of handheld ultrasound devices in diagnosis of pulmonary hypertension and right heart dysfunction in ICU patients

Performance of handheld ultrasound devices in diagnosis of pulmonary hypertension and right heart dysfunction in ICU patients

Point-of-Care Echocardiography in the Difficult-to-Image Patient in the ICU: A Narrative Review

Subcostal echocardiographic assessment of tricuspid annular kick (SEATAK): A novel independent predictor of 30-day mortality in patients with acute pulmonary embolism

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