[Interest of tricuspid annular displacement (TAD) in evaluation of right ventricular ejection fraction].
BACKGROUND
The ultrasound assessment of RV structure and function is often sub-optimal. The range of excursions of the mitral or tricuspid annulus measured in millimetre by 2D or TM-mode in centimetre per second by DTI-mode echocardiography has been shown to reflect the systolic function of both ventricles.


METHODS
We studied a new technique based on a tissue tracking algorithm that is ultrasound beam angle independent for automated detection of tricuspid annular displacement (TAD) (QLAB, Philips Medical Imaging). Twenty-six patients (pts) referred for magnetic resonance imaging (MRI) and 44 control subjects underwent a complete transthoracic echocardiography. MRI of the right ventricular ejection fraction (RVEF) was correlated by linear regression with TAD. Sixteen pts (61.5%) exhibited right ventricular systolic dysfunction (MRI RVEF<40%).


RESULTS
The MRI RVEF was positively correlated with TAD (R(2)=0,65; p<0,0001). A value of TAD <14mm predicted right ventricular dysfunction with a sensitivity of 87.5% and a specificity of 90%. Most of (90%) healthy subjects exhibited TAD values exceeding this cut-off point (mean: 16.9+/-1.64mm; range: 13.3 to 24.8mm). Negative correlation was found between TAD and age (R(2)=0,36; p<0,0001).


CONCLUSIONS
Our study is the first to correlate TAD with MRI RVEF. TAD is a simple, rapid, and non-invasive tool for right ventricular systolic function assessment.
Hugues
T
T
Service de cardiologie, hôpital Princesse-Grace, Monaco. th.hugues@yahoo.fr <th.hugues@yahoo.fr>
Ducreux
D
D
Bertora
D
D
Berthier
F
F
Lemoigne
F
F
Padovani
B
B
Gibelin
P
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D004452:Echocardiography / Q000379:methods; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000503:physiopathology; D007089:Image Enhancement / Q000379:methods; D016014:Linear Models; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000503:physiopathology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013318:Stroke Volume / Q000502:physiology*; D014261:Tricuspid Valve / Q000502:physiology*; D018497:Ventricular Dysfunction, Right / Q000175:diagnosis / Q000503:physiopathology