Use of Tricuspid Annular Plane Systolic Excursion/Pulmonary Artery Systolic Pressure As a Non-Invasive Method to Assess Right Ventricular-PA Coupling in Patients With Pulmonary Hypertension

Bashline, Michael; Simon, Marc A.

doi:10.1161/circimaging.119.009648

Cited by 12 publications

(14 citation statements)

References 20 publications

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“…The TAPSE/PASP echocardiographic ratio not only has become a meaningful prognostic parameter in patients with pulmonary artery hypertension [7,8] but also has been advocated as a useful noninvasive echocardiographic measure of RV-PA coupling based on its ability to provide valuable information regarding RV diastolic stiffness despite not being useful as a measure of RV contractility [7][8][9][10].…”

Section: Discussionmentioning

confidence: 99%

“…First, TAPSE was determined by measuring total excursion of the tricuspid annulus, from its highest position after atrial ascent to its maximal descent during ventricular systole, from the apical four-chamber view by aligning the M-mode cursor along with the movement of the lateral tricuspid annulus [6][7][8][9][10][11]. Measurements of tricuspid annular (TA) systolic velocity were then obtained using tissue Doppler imaging, as previously described, using the same anatomical orientation as for M-mode [6,11].…”

Section: Echocardiographymentioning

confidence: 99%

“…Second, continuous-wave Doppler was utilized to record the tricuspid regurgitation jet from multiple windows, and the highest velocity was then used to estimate PASP using the modified Bernoulli equation and an estimate of mean right atrial pressure using the diameter and collapse index of the inferior vena cava and the hepatic venous flow pattern [6][7][8][9][10][11].…”

Section: Echocardiographymentioning

confidence: 99%

“…In addition to these anatomical changes, there has been interest in a recently derived noninvasive echocardiographic which measures tricuspid annular plane systolic excursion (TAPSE) / PASP rate [7]. This derived variable has been shown to be a useful marker of right ventricular (RV)-pulmonary artery (PA) coupling when compared to other right heart echocardiographic measures [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

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Tricuspid Annular Systolic Velocity to Left Ventricular Outflow Velocity Time Integral Ratio: Proof of Concept Utility Analysis

López‐Candales¹,

Vallurupalli²

2021

Cureus

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BackgroundThe tricuspid annular plane systolic excursion (TAPSE) / pulmonary artery systolic pressure (PASP) ratio has been a useful marker of right ventricular (RV)-pulmonary artery coupling. However, given the intricate functional and mechanical interdependence of the right and left ventricles, we believe this ratio would be less useful when assessing reduced left ventricular (LV) systolic function. Instead, we proposed using the tricuspid annular tissue Doppler imaging systolic velocity to LV outflow tract velocity time integral ratio (TA TDI s' / LVOT VTI r) for this purpose. MethodsFor this proof-of-concept study, a retrospective analysis was conducted on 60 patients with complete echocardiographic studies while in sinus rhythm. The population was divided as follows; Group 1 included 20 individuals with normal left ventricular ejection fraction (LVEF) as well as normal RV and PASP. Group 2 was composed of 20 patients known to have been evaluated or treated for pulmonary hypertension, while group 3 was comprised of 20 patients treated for heart failure (HF). ResultsTAPSE/PASP ratios were no different from any of the studied groups. However, the proposed TA TDI s' /LVOT VTI r was statistically different among all three groups (Group 1: 0.6 ± 0.1*; Group 2: 0.5 ± 0.1°; and Group 3: 0.8 ± 0.3 # ; p < 0.001). ConclusionsBased on these results, there is now a need for additional prospective studies to explore the overall utility of using this TA TDI s' / LVOT VTI r in day-to-day routine assessments not only for diagnostic purposes but also to determine how this ratio correlates with symptoms and changes with therapy.

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Section: Discussionmentioning

confidence: 99%

Section: Echocardiographymentioning

confidence: 99%

Section: Echocardiographymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Tricuspid Annular Systolic Velocity to Left Ventricular Outflow Velocity Time Integral Ratio: Proof of Concept Utility Analysis

López‐Candales¹,

Vallurupalli²

2021

Cureus

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“…Echocardiography is a non-invasive ultrasound technique and provides RV function parameters such as tricuspid annular plane systolic excursion (TAPSE), right ventricular fractional area change (RVFAC), tricuspid annular peak systolic tissue Doppler velocity (TASV or S’) and pulmonary artery systolic pressure (PASP) for estimating hemodynamic characteristics or improving RV function in patients with PAH ( 3 , 9 ). Recently, some studies demonstrated that the ratios of TAPSE to pulmonary artery systolic pressure (PASP) were closely related to prognostic markers and have been considered a surrogate of Ees/Ea ( 10 – 14 ). The TASV/RVSP ratio, as a determinant of poor prognosis, is associated with short-term and long-term mortality ( 15 ).…”

Section: Introductionmentioning

confidence: 99%

Echocardiographic Evaluation of Initial Ambrisentan Plus Phosphodiesterase Type 5 Inhibitor on Right Ventricular Pulmonary Artery Coupling in Severe Pulmonary Arterial Hypertension Patients

Lan

Deng

Wei

et al. 2022

Front. Cardiovasc. Med.

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Introductionambrisentan and phosphodiesterase type 5 inhibitor (PDE5i) have been approved for treating patients with pulmonary arterial hypertension (PAH). Echocardiographic right ventricular pulmonary artery coupling (RVPAC) has been shown to be a valid non-invasive and alternative measurement method to assess the predicted outcomes in PAH patients. The aim of this study was to study the effect and clinical correlates of initial ambrisentan plus PDE5i combination therapy on RVPAC in patients with severe PAH.Method and ResultsWe retrospectively studied and analyzed comprehensive clinical data, hemodynamics, and echocardiography in 27 patients with severe PAH before and after 6 months of initial combination therapy. Compared with the baseline, significant improvements in RVPAC ratios were observed, including RVFAC/PASP (0.31 ± 0.10 vs. 0.44 ± 0.15%/mmHg, p < 0.001), TAPSE/PASP (0.15 ± 0.05 vs. 0.21 ± 0.06 mm/mmHg, p = 0.001), S’/PASP (0.10 ± 0.03 vs. 0.14 ± 0.05 cm/s∙mmHg, p = 0.001), and RVSV/RVESV (0.79 ± 0.22 vs. 1.02 ± 0.20, p < 0.001). Functional status indices [World Health Organization functional classifications (WHO-FC) and 6 min walk distance (6MWD) and N-terminal pro B-type natriuretic peptide (NT-proBNP) levels] showed significant improvements. Right heart catheterization (RHC) evaluations for hemodynamic measurements between baseline and the 6–12 month follow-up were sPAP (96 ± 22 vs. 86 ± 24 mmHg, p = 0.002), mPAP (64 ± 18 vs. 56 ± 17 mmHg, p < 0.001) and TPVR (17.3 ± 6.7 vs. 12.1 ± 5.4 WU, p = 0.001). Simultaneously, significant associations between RVPAC ratios and NT-proBNP levels and WHO-FC and 6MWD were observed.ConclusionAmbrisentan plus PDE-5i combination therapy resulted in a significant improvement in RVPAC in severe PAH. Importantly, RVPAC parameters correlated with known prognostic markers of PAH.

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Application of an echocardiographic index to characterize right ventricular–pulmonary arterial coupling in heart failure

Chen,

Zhang,

Lou

et al. 2024

ESC Heart Failure

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Heart failure (HF), with its high morbidity and mortality, remains a global public health issue. Right ventricular (RV) dysfunction is a sign of deterioration in the natural history of HF, and a thorough evaluation of the relationship between RV contractility and its afterload through RV–pulmonary arterial (RV–PA) coupling can aid in accurately assessing overall RV function. The ratio of RV end‐systolic elastance (Ees) to pulmonary arterial elastance (Ea) invasively measured by right heart catheterization served as the gold standard for evaluating RV–PA coupling. An echocardiographic index termed tricuspid annular plane systolic excursion/pulmonary artery systolic pressure (TAPSE/PASP) has been shown to correlate well with Ees/Ea. TAPSE/PASP is recognized as a non‐invasive surrogate of RV–PA coupling and has been extensively studied in patients with HF. This review briefly describes the methods of assessing RV–PA coupling, mainly discussing echocardiography, summarizes the clinical utility of TAPSE/PASP in patients with different HF types, and provides an overview of the available literature.

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Use of Tricuspid Annular Plane Systolic Excursion/Pulmonary Artery Systolic Pressure As a Non-Invasive Method to Assess Right Ventricular-PA Coupling in Patients With Pulmonary Hypertension

Cited by 12 publications

References 20 publications

Tricuspid Annular Systolic Velocity to Left Ventricular Outflow Velocity Time Integral Ratio: Proof of Concept Utility Analysis

Tricuspid Annular Systolic Velocity to Left Ventricular Outflow Velocity Time Integral Ratio: Proof of Concept Utility Analysis

Echocardiographic Evaluation of Initial Ambrisentan Plus Phosphodiesterase Type 5 Inhibitor on Right Ventricular Pulmonary Artery Coupling in Severe Pulmonary Arterial Hypertension Patients

Application of an echocardiographic index to characterize right ventricular–pulmonary arterial coupling in heart failure

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