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ORIGINAL ARTICLE   Free accessfree

Minerva Anestesiologica 2021 November;87(11):1200-8

DOI: 10.23736/S0375-9393.21.15464-1


lingua: Inglese

Subcostal TAPSE measured by anatomical M-mode: prospective reliability clinical study in critically ill patients

Roman ŠKULEC 1, 2, 3, 4 , Tomas PARIZEK 1, 5, 6, Barbora STADLEROVA 1, 5, Marcela BILSKA 1, 5, 6, Vladimir CERNY 1, 7, 8

1 Department of Anesthesiology, Perioperative Medicine and Intensive Care, J.E. Purkinje University, Masaryk Hospital of Usti nad Labem, Usti nad Labem, Czech Republic; 2 Faculty of Health Studies, J.E. Purkinje University, Usti nad Labem, Czech Republic; 3 Department of Anesthesiology and Intensive Care, Faculty of Medicine, Charles University, University Hospital of Hradec Kralove, Hradec Kralove, Czech Republic; 4 Emergency Medical Service of the Central Bohemian Region, Kladno, Czech Republic; 5 Faculty of Medicine, Charles University, Hradec Kralove, Czech Republic; 6 Usti and Labem Regional Emergency Medical Services, Usti and Labem, Czech Republic; 7 Department of Research and Development, Faculty of Medicine in Hradec Kralove, Charles University, University Hospital of Hradec Kralove, Hradec Kralove, Czech Republic; 8 Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, NS, Canada

BACKGROUND: Tricuspid annular plane systolic excursion (TAPSE), evaluated from a four-chamber apical view, is an echocardiographic parameter for the detection of right ventricular systolic dysfunction (RVD). We decided to assess the reliability of TAPSE measured from subcostal view (sTAPSE) by anatomical M-mode imaging (AMM) for evaluation of right ventricular systolic function and prediction of RVD in the critically ill patients by comparison with other echocardiographic parameters.
METHODS: We conducted an observational, prospective clinical study in 100 patients hospitalized in the intensive care unit. TAPSE, doppler tissue imaging-derived tricuspid lateral annular systolic velocity (DTI-S’ wave), two-dimensional fraction area change (2D FAC) and DTI-right ventricular index of myocardial performance (DTI-RIMP) were measured by transthoracic echocardiography. A subcostal four-chamber view was recorded for sTAPSE measurement. For that purpose, the cursor of AMM was aligned along the direction of the tricuspid lateral annulus movement and the amplitude of the movement was measured.
RESULTS: In a group of patients aged 64±16 years with a 31% prevalence of RVD we identified strong correlation between TAPSE and sTAPSE (r=0.963, P<0.001). sTAPSE correlated well with other measures of right ventricular systolic function (DTI-S’ wave: r=0.765; 2D FAC: r=0.701; DTI-RIMP: r=-0.661, P<0.001, respectively). The value of sTAPSE ≤15 mm predicted the presence of RVD defined by TAPSE with a sensitivity of 94.7% and specificity of 100.0%.
CONCLUSIONS: The sTAPSE measured by AMM in a population of critically ill patients has been found to be a reliable parameter of right ventricular systolic function and predicted RVD with high reliability.

KEY WORDS: Echocardiography; Heart ventricles; Critical care

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