Key result
TAPSE and TASV accurately detect RV systolic dysfunction with high diagnostic performance.
Why the study?
Measuring RV systolic function is important for patients with acute PE, but assessment is challenging due to the complex anatomy of the RV. This study evaluated RV systolic function in acute PE patients by analyzing tricuspid annular motion.
Does tricuspid annular motion analysis (TAPSE and TASV) accurately correlate with conventional RV function parameters and detect RV systolic dysfunction in patients with acute pulmonary embolism?
Observational (n=50)
No
Does tricuspid annular motion analysis (TAPSE and TASV) accurately correlate with conventional RV function parameters and detect RV systolic dysfunction in patients with acute pulmonary embolism?
TAPSE and TASV correlate well with conventional echocardiographic parameters and LogBNP, offering a simple and accurate echocardiographic method to detect RV systolic dysfunction in acute pulmonary embolism.
Answers are grounded in this paper and cite their sources.
Supports TAPSE/TASV for RV dysfunction detection in acute PE; leaves open prospective validation before clinical adoption.
BACKGROUND: Measurement of right ventricular (RV) systolic function is important for patients with acute pulmonary embolism (PE). However, assessment of RV function is a challenge due to its complex anatomy. We measured RV systolic function with analysis of tricuspid annular motion in acute PE patients. METHODS: From August 2007 to May 2011, all consecutive PE patients were prospectively included. Tricuspid annular motion was analyzed with tricuspid annular plane systolic excursion (TAPSE) and tricuspid annular systolic velocity (TASV). RESULTS: We analyzed total 50 patients (38 females, 68 ± 14 years). Mean RV fractional area change (RVFAC) was 26.2 ± 10.8%; RV Tei index 0.78 ± 0.35; TR Vmax 3.8 ± 0.5 m/sec; pulmonary vascular resistance (PVR) 3.5 ± 1.2 WU. TAPSE was 16 ± 4 mm and TASV was 11.7 ± 4.0 cm/sec. TAPSE showed significant correlations with RVFAC (r = 0.841, p < 0.001), RV Tei index (r = -0.347, p = 0.018), Log B-type natriuretic peptide (BNP) (r = -0.634, p < 0.001) and PVR (r = -0.635, p < 0.001). TASV also revealed significant correlations with RVFAC (r = 0.605, p < 0.001), RV Tei index (r = -0.380, p = 0.009), LogBNP (r = -0.477, p = 0.001) and PVR (r = -0.483, p = 0.001). The best cutoff of TAPSE for detection of RV systolic dysfunction (defined as RVFAC < 35%) was 1.75 cm [Areas under the curve (AUC) = 0.96, p < 0.001] with a sensitivity of 87% and specificity 91%. The best cutoff for TASV was 13.8 cm/sec (AUC = 0.90, p < 0.001), sensitivity 86% and specificity 78%. However, there was no statistical significance in the detection of RV dysfunction (difference = 0.07, 95% CI = -0.21-0.17, p = 0.130) between TAPSE and TASV. CONCLUSION: TAPSE and TASV showed significant correlations with conventional echocardiographic parameters of RV function and LogBNP value. These values can be used to detect RV systolic dysfunction more easily in patients with acute PE.
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Park et al. (2012) conducted an observational in Acute pulmonary embolism (n=50). Tricuspid annular plane systolic excursion (TAPSE) vs. Tricuspid annular systolic velocity (TASV) and conventional RVFAC (<35%) was evaluated on Detection of right ventricular systolic dysfunction (defined as RVFAC < 35%) using ROC AUC comparison between TAPSE and TASV (AUC difference 0.07, 95% CI -0.21-0.17, p=0.130). TAPSE (cutoff 1.75 cm, AUC 0.96) and TASV (cutoff 13.8 cm/s, AUC 0.90) accurately detected RV systolic dysfunction (RVFAC <35%, p<0.001) and strongly correlated with RVFAC (r=0.841 and r=0.605).
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