title: Simple prediction of right ventricular ejection fraction using tricuspid annular plane systolic excursion in pulmonary hypertension.
abstract: The present study examined whether tricuspid annular plane systolic excursion (TAPSE) can simply predict right ventricular ejection fraction (RVEF) in patients with pulmonary hypertension (PH). The TAPSE cut-off value to predict reduced RVEF was also evaluated. The association between TAPSE and cardiac magnetic resonance imaging (CMRI)-derived RVEF was examined in 53 PH patients. The accuracy of the prediction equation to calculate RVEF using TAPSE was also evaluated. In PH patients, TAPSE was strongly correlated with CMRI-derived RVEF in PH patients (r = 0.86, p < 0.0001). We then examined the accuracy of the two equations: the original regression equation (RVEF = 2.01 × TAPSE + 0.6) and the simplified prediction equation (RVEF = 2 × TAPSE). Bland-Altman plot showed that the mean difference ± limits of agreement was 0.0 ± 10.6 for the original equation and -0.6 ± 10.6 for the simplified equation. Intraclass correlation coefficient was 0.84 for the original and 0.82 for the simplified equation. Normal RVEF was considered to be ≥40% based on the data from 53 matched controls, and the best TAPSE cut-off value to determine reduced RVEF (<40%) was calculated to be 19.7 mm (sensitivity 88.9%, specificity 84.6%). A simple equation of RVEF = 2 × TAPSE enables easy prediction of RVEF using TAPSE, an easily measurable M-mode index of echocardiography. TAPSE of 19.7 mm predicts reduced RVEF in PH patients with clinically acceptable sensitivity and specificity.
authors.affiliation: First Department of Medicine, Hokkaido University Hospital, North 14, West 5, Kita-ku, Sapporo, 060-8648, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Sato
authors.forename: Ichizo
authors.initials: I
authors.lastname: Tsujino
authors.forename: Noriko
authors.initials: N
authors.lastname: Oyama-Manabe
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ohira
authors.forename: Yoichi M
authors.initials: YM
authors.lastname: Ito
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Sugimori
authors.forename: Asuka
authors.initials: A
authors.lastname: Yamada
authors.forename: Chisa
authors.initials: C
authors.lastname: Takashina
authors.forename: Taku
authors.initials: T
authors.lastname: Watanabe
authors.forename: Masaharu
authors.initials: M
authors.lastname: Nishimura
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012044:Regression Analysis; D015203:Reproducibility of Results; D013318:Stroke Volume; D013599:Systole; D014261:Tricuspid Valve / Q000000981:diagnostic imaging* / Q000503:physiopathology; D014463:Ultrasonography; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016278:Ventricular Function, Right