title: Tricuspid annular plane systolic excursion and response to cardiac resynchronization therapy: results from the REVERSE trial.
abstract: BACKGROUND
  The aims of this study were to evaluate tricuspid annular plane systolic excursion (TAPSE) as a predictor of left ventricular (LV) reverse remodeling and clinical benefit of cardiac synchronization therapy (CRT) and to evaluate the effect of CRT on TAPSE in patients with mildly symptomatic systolic heart failure as a substudy of the REsyncronization reVErses Remodeling in Systolic left vEntricular dysfunction (REVERSE) trial.
  
  
  RESULTS
  Patients (n = 450) were randomized in a 2:1 fashion to CRT ON or CRT OFF and followed for 12 months. End points were reverse LV remodeling defined as a reduction in LV end-systolic volume of ≥20 mL/m(2) by echocardiography and a clinical composite score, defined as freedom from clinical deterioration. TAPSE was an independent predictor of reverse remodeling, OR = 1.08 (95% CI 1.03-1.14) per mm increase and a favorable clinical composite score, OR = 1.08 (95% CI 1.02-1.14). No significant interactions were observed between TAPSE and CRT ON. CRT ON was not associated with a significant effect on TAPSE compared to CRT OFF, -0.8 ± 4.7 vs. 0.3 ± 5 mm, P = .06.
  
  
  CONCLUSIONS
  TAPSE is an independent predictor of clinical response and improved reverse remodeling in patients with mildly symptomatic heart failure. The effect of CRT is not modified by TAPSE in the present population. CRT is not associated with a clinically significant effect on TAPSE.
authors.affiliation: The Heart Centre, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, Copenhagen Ø, Denmark. jesper.kjaergaard@rh.regionh.dk
authors.forename: Jesper
authors.initials: J
authors.lastname: Kjaergaard
authors.forename: Stefano
authors.initials: S
authors.lastname: Ghio
authors.forename: Martin
authors.initials: M
authors.lastname: St John Sutton
authors.forename: Christian
authors.initials: C
authors.lastname: Hassager
mesh_terms: D000368:Aged; D058406:Cardiac Resynchronization Therapy / Q000379:methods*; D058409:Cardiac Resynchronization Therapy Devices; D016001:Confidence Intervals; D005080:Exercise Test; D005260:Female; D006305:Health Status Indicators; D054143:Heart Failure, Systolic / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000628:therapy*; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011379:Prognosis; D013318:Stroke Volume; D016896:Treatment Outcome; D014463:Ultrasonography; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling