True relationship between tricuspid annular motion and velocity displacement components: Potential role in assessing right ventricular decoupling

Abstract

AbstractBackgroundAlthough measures of longitudinal displacement of the tricuspid annulus measured by M‐mode as tricuspid annular systolic plane excursion (TAPSE) and systolic velocity by tissue Doppler imaging (TA TDI s) are routinely used for assessment of right ventricular (RV) systolic function; these measures describe different phenomena and should not be used interchangeably.MethodsPreviously published data was used to determine the individual relationship between TAPSE and TA TDI s with increasing pulmonary artery systolic pressures (PASP).ResultsIn this retrospective analysis, 488 patients were divided into 2 groups based on TAPSE (Group 1: <1.8 cm and Group 2: ≥1.8 cm). A robust correlation (R = .79) between TAPSE and TA TDI s noted for the entire population. However, a statistically lower correlation (R = .43) was seen between Group 1 and Group 2 (R = .65; p < .0047). With increasing pulmonary pressures, only PASP (p < .0001) and TA TDI s (p < .0001) discriminated between low and normal TAPSE/PASP values. Suggesting that a TA TDI s/PASP ratio would be most useful than TAPSE/PASP with a specificity of 80%.ConclusionsSignificant differences exist between TAPSE and TA TDI s, particularly at low TAPSE values with increased PASP, were uncoupling occurs. Our data seems to suggest that TA TDI s/PASP would be most useful than TAPSE/PASP ratio. Future studies should address, if abnormalities in the material properties along the RV free wall account for these differences seen between TAPSE and TA TDI s.