Efficacy of Tricuspid Annular Plane Systolic Excursion (TAPSE) in Patients with Pulmonary Hypertension

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  • 肺高血圧患者における三尖弁収縮期移動距離の有用性

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Background: The systolic excursion of the tricuspid annular plane (TAPSE) reflects right ventricular (RV) ejection fraction. Since RV function may be an important determinant of cardiac output and exercise capacity in pulmonary arterial hypertension (PAH), we hypothesized that TAPSE would correlate with cardiac function and exercise tolerance in patients with PAH.<br>Methods: We retrospectively reviewed the data from 58 patients (age 52±16 years) with idiopathic PAH (mean pulmonary arterial pressure 51±20 mmHg) who underwent right heart catheterization within 48 hours of transthoracic echocardiography between January 2009 and August 2009, who were in sinus rhythm and had no more than moderate tricuspid regurgitation. We analyzed the relationships between TAPSE and the following parameters: cardiac index, pulmonary vascular resistance, and mean pulmonary arterial pressure assessed by cardiac catheterization, peak systolic tricuspid pressure gradient measured by echocardiography, 6-minute walking distance, plasma BNP level, and serum uric acid level.<br>Results: TAPSE (17±8 mm) significantly correlated with cardiac index (2.3±1.4 l/min/m2: r=0.48, p<0.05), 6-minute walking distance (447±139 m: r=0.58, p<0.01), pulmonary vascular resistance (1221±960 dynes/sec/m-5: r=-0.57, p<0.01), and uric acid level (7.5±3.4 mg/dl: r=-0.24, p<0.05), but not correlated with BNP level (530±284 pg/ml), mean pulmonary arterial pressure (51±20 mmHg), and peak systolic tricuspid pressure gradient (76±39 mmHg).<br>Conclusion: In patients with PAH, RV function evaluated with TAPSE significantly correlates with cardiac output and exercise tolerance. Thus, TAPSE is a useful echocardiographic measure of RV function in patients with PAH.

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