Tricuspid Annular Plane Systolic Excursion (TAPSE) correlates with mean pulmonary artery pressure especially 10 years after pediatric heart transplantation

Abstract

Tricuspid annular plane systolic excursion (TAPSE) is important in the noninvasive echocardiographic assessment of right heart function. This retrospective observational study shows correlations of TAPSE with invasive right heart catheterization parameters after pediatric heart transplantation (HTx). The study included patients after pediatric HTx with cardiac catheterizations in 2018/2019 and measurement of TAPSE (n = 52 patients with 57 examinations; 50.9% adults, 52.6% female, median age: 18.54 years). TAPSE was compared with normal values. Stepwise, linear and multiple regression were used to show influencing variables on TAPSE. Mean TAPSE z-score was −3.48 (SD: 2.25) and 68.4% of HTx-recipients showed abnormally reduced TAPSE (z-score ←2) compared to normal values. Multiple regression (p-value <0.001; corrected R 2 = 0.338) showed significant correlations of time since HTx (p-value <0.001) and mPAP (p-value: 0.008) with TAPSE z-scores. Divided into subgroups (time since HTx <10 and ≥10 years), TAPSE and mPAP correlated only ≥10 years after HTx (p-value = 0.002). This study provides data of TAPSE even ≥10 years after pediatric HTx. Most patients showed a decreased TAPSE early after HTx, which improved over time. TAPSE z-scores correlated significantly with time since HTx and mPAP, especially ≥10 years post-HTx. Therefore, TAPSE must be used carefully in the early follow-up.

My Approach to Echocardiographic Evaluation after Pediatric Heart Transplantation to Control Rejection and/or Graft Vascular Disease

“…They also demonstrated an association between a reduction in TAPSE and an increase in mean pulmonary artery pressure calculated by cardiac catheterization 10 years after transplantation. 14 Pediatric patients show a decrease in TAPSE during an episode of rejection, and the values improve after resolution of the condition, as demonstrated in a retrospective study carried out by Arthur et al, which evaluated 44 pediatric heart transplant patients. 15…”

Ventricular Function and Cardio-Ankle Vascular Index in Patients With Pulmonary Artery Hypertension

“…[69][70][71] But in some others, the TAPSE was not associated with stroke volume 72 or had the poor correlation with RV EF, than right ventricular fractional area change, 73 or had a poor association with alternative RV function parameters like Tei-index and systolic excursion velocity of lateral tricuspid annulus (S´), 74 or correlated with mean pulmonary BP in 10 years, but not in earlier period after pediatric heart transplantation. 75 Besides, Chio et al demonstrated the different prognostic value of TAPSE in association with other TTE parameters (LV eccentricity index, tricuspid regurgitation). 76 This means some TTE parameters, including time intervals, need to be used for evaluation of the RV function.…”

Como Eu Faço Avaliação Ecocardiográfica no Pós-Transplante Cardíaco Pediátrico para Controle de Rejeição e/ou Doença Vascular do Enxerto

“…Além disso, demonstraram associação entre redução do TAPSE e aumento da pressão média da artéria pulmonar calculada em cateterismo cardíaco após 10 anos do enxerto. 14 Pacientes pediátricos apresentam redução do TAPSE durante episódio de rejeição com melhora dos valores após resolução do…”