Prevalence of, associations with, and prognostic value of Tricuspid Annular Plane Systolic Excursion (TAPSE) among out-patients referred for the evaluation of heart failure

Damy, T. et al. (2012) Prevalence of, associations with, and prognostic value of Tricuspid Annular Plane Systolic Excursion (TAPSE) among out-patients referred for the evaluation of heart failure. Journal of Cardiac Failure, 18(3), pp. 216-225. (doi:10.1016/j.cardfail.2011.12.003) (PMID:22385942)

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Abstract

Background: Prevalence, predictors, and prognostic value of right ventricular (RV) function measured by the tricuspid annular plane systolic excursion (TAPSE) in patients with chronic heart failure (CHF) symptoms with a broad range of left ventricular ejection fraction (LVEF) are unknown. Methods and Results: Of 1,547 patients, mean (±SD) age was 71 ± 11 years, 48% were women, median (interquartile range [IQR]) TAPSE was 18.5 (14.0–22.7) mm, mean LVEF was 47 ± 16%, 47% had LVEF ≤45% and 67% were diagnosed with CHF, defined as systolic (S-HF) if LVEF was ≤45% and as heart failure with preserved ejection fraction (HFPEF) if LVEF was >45% and treated with a loop diuretic. During a median (IQR) follow-up of 63 (41–75) months, mortality was 34%. In multivariable analysis, increasing age, N-terminal pro–B-type natriuretic peptide (NT-proBNP), New York Heart Association functional class, right atrial volume index, and transtricuspid pressure gradient; lower TAPSE, diastolic blood pressure, and hemoglobin; and atrial fibrillation (AF) or COPD were associated with an adverse prognosis. Receiver operating characteristic curve analysis identified a TAPSE of 15.9 mm as the best prognostic threshold (P = .0001); 47% of S-HF and 20% of HFPEF had a TAPSE of <15.9 mm. The main associations with a TAPSE <15.9 mm were higher NT-proBNP, presence of atrial fibrillation and presence of LV systolic dysfunction. Conclusions: In patients with CHF, low values for TAPSE are common, especially in those with reduced LVEF. TAPSE, unlike LVEF, was an independent predictor of outcome.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Cleland, Professor John
Authors: Damy, T., Kallvikbacka-Bennett, A., Goode, K., Khaleva, O., Lewinter, C., Hobkirk, J., Nikitin, N. P., Dubois-Randé, J.-L., Hittinger, L., Clark, A. L., and Cleland, J. G.F.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
Journal Name:Journal of Cardiac Failure
Publisher:Elsevier
ISSN:1071-9164
ISSN (Online):1532-8414
Published Online:26 January 2012

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