title: Improvement in Tricuspid Annular Plane Systolic Excursion with Pulmonary Hypertension Therapy in Pediatric Patients.
abstract: BACKGROUND
  Tricuspid annular plane systolic excursion (TAPSE) has emerged as a novel and reliable measure of right ventricular (RV) function. The purpose of this study was to determine the effect of pulmonary hypertension (PH) therapy on TAPSE in pediatric patients and compare TAPSE to other quantitative measures of RV function.
  
  
  METHODS
  A retrospective review of medical records and echocardiograms of patients in the PH clinic from January 2011 to August 2013 was done. Echocardiograms were analyzed prior to initiation or addition of a PH drug and at least 8 weeks later. Following quantitative measures of RV function were compared: TAPSE, TAPSE age-based z-score, RV fractional area change (RVFAC), tricuspid annular S', tricuspid inflow E/tricuspid annular E' velocity (TV E/E'), and RV myocardial performance index (RVMPI).
  
  
  RESULTS
  Of the 37 patients included in this study (median age 0.6 years), 23 (62.2%) were treatment naive and others had a new PH drug added to their regimen at the time of the baseline echocardiogram. The median duration between the baseline and follow-up echocardiogram was 8 (2-25) months. There was a significant improvement in TAPSE and TAPSE age-based z-score on the follow-up echocardiogram. RVFAC, tricuspid S', TV E/E', and RVMPI did not show a statistically significant change.
  
  
  CONCLUSIONS
  In contrast to the other echocardiographic markers of RV function, TAPSE, and TAPSE age-based z-score significantly improve after initiation or addition of PH therapy and can be used for serial noninvasive monitoring of RV function in pediatric PH patients.
authors.affiliation: Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia.
authors.forename: Maria
authors.initials: M
authors.lastname: Bano
authors.affiliation: Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia.
authors.forename: Usama B
authors.initials: UB
authors.lastname: Kanaan
authors.affiliation: Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia.
authors.forename: Alexandra C
authors.initials: AC
authors.lastname: Ehrlich
authors.affiliation: Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia.
authors.forename: Courtney
authors.initials: C
authors.lastname: McCracken
authors.affiliation: Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia.
authors.forename: Gemma
authors.initials: G
authors.lastname: Morrow
authors.affiliation: Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia.
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Oster
authors.affiliation: Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia.
authors.forename: Ritu
authors.initials: R
authors.lastname: Sachdeva
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use*; D002675:Child, Preschool; D004452:Echocardiography / Q000379:methods; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008297:Male; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000000981:diagnostic imaging*; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging* / Q000209:etiology / Q000517:prevention & control*
chemical_list: D000959:Antihypertensive Agents
keywords: pulmonary hypertension; tissue Doppler echocardiography