TAPSE: A Red Herring After Cardiac Surgery

Maus, Timothy M.

doi:10.1053/j.jvca.2017.11.013

Cited by 14 publications

(7 citation statements)

References 10 publications

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“…On TEE, RV is triangular in the ME 4CH view, has a “wrap-around” appearance in the ME RV inflow-outflow view, and a crescent shape in the transgastric short-axis view. RV has complex peristaltic-like contraction with a major contribution from the longitudinal contraction 9). However, the contraction also involves the inward motion of the free wall and apex, and there is also a contribution of the infundibular or outflow tract portion 9)…”

Section: Discussionmentioning

confidence: 99%

“…TAPSE and m-TAPSE measure the longitudinal excursion of the tricuspid annulus toward the apex. RV FAC in ME 4CH view measures longitudinal and the inward motion of the free wall, but does not take into account the contribution of the infundibular or outflow tract portion 9)…”

Section: Discussionmentioning

confidence: 99%

“…This is especially helpful when acoustic shadowing from mitral valve calcification or mechanical valve replacement covers the RV free wall or the septum. The RV is more trabeculated than the left ventricle, which limits endocardial delineation and hence the accuracy of RV FAC 9). Alignment of M-mode with the lateral tricuspid annulus in the ME 4CH view is difficult using TEE.…”

Section: Discussionmentioning

confidence: 99%

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Modified Tricuspid Annular Plane Systolic Excursion for Assessment of Right Ventricular Systolic Function

Dhawan

Makhija

Choudhury

et al. 2019

J Cardiovasc Imaging

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BACKGROUNDTricuspid annular plane systolic excursion (TAPSE) has become a popular tool for assessing right ventricular (RV) systolic function because of its ease of application. TAPSE using transesophageal echocardiography (TEE) is limited by alignment with the lateral wall of the RV. Modified TAPSE (m-TAPSE) is a novel method for measuring TAPSE. m-TAPSE is the difference in the ‘apical to lateral tricuspid annulus distance’ during diastole and systole. The aim of the present study was to compare prospectively m-TAPSE with the most commonly used parameter TAPSE and near-gold standard 2D echocardiographic parameter RV fractional area change (RV FAC).METHODSWe conducted a prospective observational study of 125 consecutive patients undergoing coronary artery bypass graft surgery in a single tertiary care center. Post-anesthetic induction TAPSE was recorded using transthoracic echocardiography (TTE). m-TAPSE was recorded using TEE in the mid-esophageal four-chamber view. RV FAC was also assessed using TEE. m-TAPSE < 16 mm, TAPSE < 16 mm and RV FAC < 35% were taken as cut-offs for RV systolic dysfunction. Correlations were assessed using the Pearson correlation coefficient. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated using 2 × 2 cross table.RESULTSm-TAPSE was significantly correlated with TAPSE (r = 0.797, p < 0.001). Similarly, a significant correlation was observed between m-TAPSE and RV FAC (r = 0.602, p < 0.001). The sensitivity, specificity, PPV, NPV, and accuracy of m-TAPSE were 100%, 98.3%, 80%, 100% and 98.4%, respectively.CONCLUSIONSm-TAPSE correlated well with both RV FAC and TAPSE. Therefore, m-TAPSE can be considered an easily measurable alternative parameter for evaluating RV systolic function in a busy intraoperative setting.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Modified Tricuspid Annular Plane Systolic Excursion for Assessment of Right Ventricular Systolic Function

Dhawan

Makhija

Choudhury

et al. 2019

J Cardiovasc Imaging

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“…Moreover, TAPSE may not be an optimal parameter in the perioperative setting of cardiac surgery [31]. Several trials reported about reduced TAPSE after cardiac surgery, explaining this condition with pericardiotomy [32] or surgery and extracorporeal circulation [33], while global RV function was preserved.…”

Section: Conventional Echocardiographic Parametersmentioning

confidence: 99%

Role of Echocardiography for the Perioperative Assessment of the Right Ventricle

Labus

Uhlig

2021

Curr Anesthesiol Rep

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Purpose of Review This review aims to highlight the perioperative echocardiographic evaluation of right ventricular (RV) function with strengths and limitations of commonly used and evolving techniques. It explains the value of transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) and describes the perioperative changes of RV function echocardiographers should be aware of. Recent Findings RV dysfunction is an entity with strong influence on outcome. However, its definition and assessment in the perioperative interval are not well-defined. Moreover, values assessed by TTE and TEE are not interchangeable; while some parameters seem to correlate well, others do not. Myocardial strain analysis and three-dimensional echocardiography may overcome the limitations of conventional echocardiographic measures and provide further insight into perioperative cardiac mechanics. Summary Echocardiography has become an essential part of modern anesthesiology in patients with RV dysfunction. It offers the opportunity to evaluate not only global but also regional RV function and distinguish alterations of RV contraction.

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“…Both TAPSE and S' have been shown to be inaccurate measures of global function after the pericardium has been opened. 20,21 Right ventricular fractional area change (FAC) provides a more representative evaluation in the setting of cardiac surgery, 22 but omits the contribution of the RVOT, and suffers from greater interobserver variability. 23 Right ventricular index of myocardial performance (RIMP) is load dependent and is unreliable when right atrial pressures are elevated.…”

mentioning

confidence: 99%

Echocardiography in Weaning Right Ventricular Mechanical Circulatory Support: Are We Measuring the Right Stuff?

Roscoe

Zochios

2022

Journal of Cardiothoracic and Vascular Anesthesia

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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TAPSE: A Red Herring After Cardiac Surgery

Cited by 14 publications

References 10 publications

Modified Tricuspid Annular Plane Systolic Excursion for Assessment of Right Ventricular Systolic Function

Modified Tricuspid Annular Plane Systolic Excursion for Assessment of Right Ventricular Systolic Function

Role of Echocardiography for the Perioperative Assessment of the Right Ventricle

Echocardiography in Weaning Right Ventricular Mechanical Circulatory Support: Are We Measuring the Right Stuff?

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