The associations between tricuspid annular plane systolic excursion (TAPSE), ventricular dyssynchrony, and ventricular interaction in heart failure patients

Saurabh Gupta, Farman Khan, Mia Shapiro, Sarah G. Weeks, Sheldon E. Litwin, Andrew D. Michaels

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Aims: Ventricular interactions may be mediated by loading conditions and biventricular timing and coordination. We sought to understand the relationships between right (RV) and left ventricular (LV) function and dyssynchrony, examine the RV correlates of LV dyssynchrony, and determine whether improved loading conditions affect inter-ventricular interaction. Methods and results: In 25 heart failure patients [15 with left ventricular ejection fraction (LVEF) <40%; 10 with LVEF ≥ 50%], Doppler echocardiography and invasive bi-ventricular pressure-volume haemodynamics were obtained at baseline and 30 min after infusion of the recombinant B-type natriuretic peptide vasodilator nesiritide. RV and LV intra-ventricular dyssynchrony was measured invasively using a pressure-conductance catheter. Patients with reduced LVEF had greater LV dyssynchrony (31 ± 3 vs. 24 ± 7%; P = 0.003) compared to those with preserved LVEF. Tricuspid annular plane systolic excursion (TAPSE) had the highest correlation with LV dyssynchrony (r = -0.52; P = 0.0002) compared to other RV echocardiographic parameters. The association between TAPSE and LV dyssynchrony was independent of RVEF and LVEF (P = 0.008). There were no acute changes in the correlations between LV dyssynchrony and TAPSE after nesiritide. Conclusion: TAPSE and LV dyssynchrony are strongly associated, independent of RV and LV ejection fraction. Of the RV echocardiographic parameters, TAPSE has the highest predictive value of LV dyssynchrony, and remained significant after vasodilator unloading.

Original languageEnglish (US)
Pages (from-to)766-771
Number of pages6
JournalEuropean Journal of Echocardiography
Volume9
Issue number6
DOIs
StatePublished - Nov 2008
Externally publishedYes

Fingerprint

Stroke Volume
Heart Failure
Brain Natriuretic Peptide
Vasodilator Agents
Right Ventricular Function
Doppler Echocardiography
Ventricular Pressure
Left Ventricular Function
Catheters
Hemodynamics
Pressure

Keywords

  • Brain natriuretic peptide
  • Dyssynchrony
  • Heart failure
  • Hemodynamics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

The associations between tricuspid annular plane systolic excursion (TAPSE), ventricular dyssynchrony, and ventricular interaction in heart failure patients. / Gupta, Saurabh; Khan, Farman; Shapiro, Mia; Weeks, Sarah G.; Litwin, Sheldon E.; Michaels, Andrew D.

In: European Journal of Echocardiography, Vol. 9, No. 6, 11.2008, p. 766-771.

Research output: Contribution to journalArticle

Gupta, Saurabh ; Khan, Farman ; Shapiro, Mia ; Weeks, Sarah G. ; Litwin, Sheldon E. ; Michaels, Andrew D. / The associations between tricuspid annular plane systolic excursion (TAPSE), ventricular dyssynchrony, and ventricular interaction in heart failure patients. In: European Journal of Echocardiography. 2008 ; Vol. 9, No. 6. pp. 766-771.
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AU - Michaels, Andrew D.

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AB - Aims: Ventricular interactions may be mediated by loading conditions and biventricular timing and coordination. We sought to understand the relationships between right (RV) and left ventricular (LV) function and dyssynchrony, examine the RV correlates of LV dyssynchrony, and determine whether improved loading conditions affect inter-ventricular interaction. Methods and results: In 25 heart failure patients [15 with left ventricular ejection fraction (LVEF) <40%; 10 with LVEF ≥ 50%], Doppler echocardiography and invasive bi-ventricular pressure-volume haemodynamics were obtained at baseline and 30 min after infusion of the recombinant B-type natriuretic peptide vasodilator nesiritide. RV and LV intra-ventricular dyssynchrony was measured invasively using a pressure-conductance catheter. Patients with reduced LVEF had greater LV dyssynchrony (31 ± 3 vs. 24 ± 7%; P = 0.003) compared to those with preserved LVEF. Tricuspid annular plane systolic excursion (TAPSE) had the highest correlation with LV dyssynchrony (r = -0.52; P = 0.0002) compared to other RV echocardiographic parameters. The association between TAPSE and LV dyssynchrony was independent of RVEF and LVEF (P = 0.008). There were no acute changes in the correlations between LV dyssynchrony and TAPSE after nesiritide. Conclusion: TAPSE and LV dyssynchrony are strongly associated, independent of RV and LV ejection fraction. Of the RV echocardiographic parameters, TAPSE has the highest predictive value of LV dyssynchrony, and remained significant after vasodilator unloading.

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