The relation between quantitative right ventricular ejection fraction and indices of tricuspid annular motion and myocardial performance

Miller, D.Craig; Farah, Michel G.; Liner, Anna; Fox, Keith; Schluchter, Mark D.; Hoit, Brian D.

doi:10.1016/j.echo.2004.01.010

Cited by 369 publications

(286 citation statements)

References 20 publications

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“…14,15 There has been a wide range of correlations between TAPSE and other measures of RV function. Good correlations were obtained comparing TAPSE with RVEF, [16][17][18][19][20] and better correlations were obtained comparing TAPSE with RV fractional area of change 6,12 and global RV strain. 21 Correlations were more modest when compared with RVEF using magnetic resonance imaging.…”

Section: Discussionmentioning

confidence: 89%

Evaluation of TAPSE as a measure of right ventricular output

Tousignant

Kim

Papa

et al. 2012

Can J Anesth/J Can Anesth

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Purpose This study was designed to show the relationship between tricuspid annular plane systolic excursion (TAPSE) and stroke volume (SV) by thermodilution using three different methods and also to assess whether TAPSE can track hemodynamic changes associated with volume loading and ephedrine administration. Methods This was an observational study in 61 elective patients with a pulmonary artery catheter who were undergoing coronary artery bypass graft surgery in a cardiac surgical centre. We measured TAPSE by three methods using transesophageal echocardiography: M mode, speckle tracking at the lateral wall, and tissue tracking at the inferior wall. There were two interventions: leg raising (volume recruitment) or administration of ephedrine 5 mg iv. Echo and hemodynamic measurements were performed before and after each intervention.Results Eleven patients were excluded due to poor imaging. There were 26 patients in the leg raising group and 24 patients in the ephedrine group. The correlation coefficient between stroke volume (SV) and TAPSE by M mode, speckle tracking, and tissue tracking was 0.48, 0.44, and 0.09, respectively. There was a significant increase in SV following each intervention; however, the changes in TAPSE by any method and velocity were not large enough to reach statistical significance. Conclusion Tricuspid annular plane systolic excursion by M mode and by speckle tracking correlates modestly with SV. There was no correlation between TAPSE and SV by tissue tracking at the inferior wall of the right ventricle. Tricuspid annular plane systolic excursion by M mode and by speckle tracking does not track changes in SV following either volume loading or ephedrine administration. RésuméObjectif Cette e´tude a e´te´conçue pour montrer le rapport entre le de´placement systolique du plan de l'anneau tricuspidien (TAPSE) avec le volume d'e´jection systolique (SV) par thermodilution en utilisant trois me´thodes diffe´rentes et aussi pour de´terminer si le TAPSE peut suivre les modifications he´modynamiques associe´es a`une charge volumique et a`une administration d'e´phe´drine. Méthodes Il s'agit d'une e´tude observationnelle mene´e chez 61 patients se´lectionne´s porteurs d'un cathe´ter de l'arte`re pulmonaire qui devaient subir un pontage coronarien dans un centre de chirurgie cardiaque. Nous avons mesure´le TAPSE par trois me´thodes diffe´rentes al 'aide d'une e´chocardiographie transoesophagienne: mode M;suivi de granularite´s (speckle tracking) sur la paroi late´rale; et suivi de tissu (tissue tracking) sur la paroi infe´rieure. Il y a eu deux interventions: jambes releve´es

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Section: Discussionmentioning

confidence: 89%

Evaluation of TAPSE as a measure of right ventricular output

Tousignant

Kim

Papa

et al. 2012

Can J Anesth/J Can Anesth

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“…Standard two-dimensional echocardiographic evaluation of RV size and function was performed (12). In addition, RV end-diastolic and end-systolic areas were measured from the apical four-chamber view to calculate right ventricular fractional area change (RVFAC) (12)(13)(14).…”

Section: Standard Echocardiographymentioning

confidence: 99%

“…Maximal tricuspid annular plane systolic excursion (TAPSE) was determined by measurement of the tricuspid annulus from its highest position after atrial ascent to its lowest position during ventricular systole (13).…”

Section: Standard Echocardiographymentioning

confidence: 99%

Differential strain and velocity generation along the right ventricular free wall in pulmonary hypertension

López‐Candales

Rajagopalan

Gulyasy

et al. 2009

Canadian Journal of Cardiology

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T issue Doppler imaging (TDI) has allowed for better quantification of myocardial function by demonstrating specific regional changes in strain generation and in the development of myocardial velocities (1-4). Significant differences in these two TDI indexes (ie, strain and velocity) have been reported for both the right and left ventricles. These differences are likely explained, in part, by the different loading conditions and compliance properties of these two chambers (5,6). However, equally important are the differences noted in myocardial fibre arrangement between the right and left ventricles (7-9). Regardless of the mechanism(s), it has been described that, in contrast to the homogeneously distributed deformation properties within the left ventricle, strain values are inhomogeneously distributed in the right ventricle and show a reverse baso-apical gradient, reaching their highest values toward apical segments and the outflow tract (7,10).Because the Cardiovascular Institute at the University of Pittsburgh (Pittsburgh, Pennsylvania) previously demonstrated that pulmonary hypertension (PH) results in a significant right ventricular (RV) free wall (RVFW) mechanical delay (11), we assessed the effect of the degree of pulmonary arterial systolic pressure (PASP) on the RVFW strain gradient and on myocardial velocity generation to obtain a better understanding of RV failure in PH. METHODS Study populationIn addition to TDI information, complete echocardiographic data, including an acceptable tricuspid regurgitation signal to estimate RV systolic pressure, were recorded in 31 consecutive patients with a history of PH who were referred for an echocardiographic examination. CliniCal StuDieS©2009 Pulsus Group Inc. All rights reserved BACKGROUND:In contrast to the homogeneously distributed deformation properties within the left ventricle, the right ventricular (RV) free wall (RVFW) shows a more inhomogeneous distribution. It has been demonstrated that pulmonary hypertension (PH) results in significant RVFW mechanical delay. OBJECTivE: To assess the effect of the degree of pulmonary arterial systolic pressure on the RVFW strain gradient and on myocardial velocity generation. METHODS: Peak longitudinal strain and velocity data were collected from three different segments (basal, mid-and apical) of the RVFW in 17 normal individuals and 31 PH patients. RESULTS: A total of 144 RV wall segments were analyzed. RVFW strain values in individuals without PH were higher in the mid and apical segments than in the basal segment. In contrast, RVFW strain in PH patients was higher in basal segments and diminished toward the apex. In terms of RVFW velocities, both groups showed decremental values from basal to apical segments. Basal and mid-RVFW velocities were significantly lower in PH patients than in individuals without PH. CONCLUSiONS: PH results in significant alterations of strain and velocity generation that occurs along the RVFW. Of these abnormalities, the reduction in strain from the mid and apical RVFW segments was mos...

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“…However, echocardiographic calculations are limited by geometrical assumptions. Though echocardiographic parameters like tricuspid annular plane systolic excursion, FAC (fractional area change), MPI (myocardial performance index) are useful in assessing RV function, they are known to be technically challenging and incomplete (19,20).…”

Section: Discussionmentioning

confidence: 99%

Right ventricular failure predicted from right bundle branch block: cardiac magnetic resonance imaging validation

Devarapally

Arora

Ahmad

et al. 2016

Cardiovasc. Diagn. Ther.

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Background: Right ventricular (RV) failure has proven to be independently associated with adverse outcomes. Electrocardiographic parameters assessing RV function are largely unknown, making echocardiography the first line for RV function assessment. It is however, limited by geometrical assumptions and is inferior to cardiac magnetic resonance imaging (CMRI) which is widely regarded as the most accurate tool for assessing RV function. Methods:We seek to determine the correlation of ECG parameters of right bundle branch block (RBBB) with RV ejection fraction (EF) and RV dimensions using the CMRI. QRS duration, R amplitude and R' duration were obtained from precordial lead V1; S duration and amplitude were obtained from lead I and AVL. RV systolic dysfunction was defined as RV EF <40%. RV systolic dysfunction group (mean EF of 24±10%) were compared with normal RV systolic function group which acted as control (mean EF of 48±8%). CMRI and ECG parameters were compared between the two groups. Rank correlations and scatter diagrams between individual CMRI parameters and ECG parameters were done using medcalc for windows, version 12.5. Sensitivity, specificity and area under the curve (AUC) were calculated.Results: RV systolic dysfunction group was found to have larger RV end systolic volumes (90±42 vs. 59±40 mL, P=0.02). ECG evaluation of RV dysfunction group revealed longer R' duration (103±22 vs.84±18 msec, P=0.005) as compared to the control group. The specificity of R' duration >100 msec to detect RV systolic dysfunction was found to be 93%. R' duration was found to have an inverse correlation with RV EF (r=−0.49, P=0.007).Conclusions: Larger RV end systolic volumes seen with RV dysfunction can affect the latter part of right bundle branch leading to prolonged R' duration. We here found prolonged R' duration in lead V1 to have a highly specific inverse correlation to RV systolic function. ECG can be used as an inexpensive tool for RV function assessment and should be used alongside echocardiography to evaluate RV dysfunction when CMRI is not available.

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The relation between quantitative right ventricular ejection fraction and indices of tricuspid annular motion and myocardial performance

Cited by 369 publications

References 20 publications

Evaluation of TAPSE as a measure of right ventricular output

Evaluation of TAPSE as a measure of right ventricular output

Differential strain and velocity generation along the right ventricular free wall in pulmonary hypertension

Right ventricular failure predicted from right bundle branch block: cardiac magnetic resonance imaging validation

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