title: Tricuspid annular plane systolic excursion inaccuracy to assess right ventricular function in patients with previous tricuspid annulopasty.
abstract: OBJECTIVE
  The clinical and prognostic usefulness of tricuspid annular plane systolic excursion (TAPSE) is well established. However, the ability of TAPSE to assess right ventricular (RV) function in patients with previous tricuspid valve annulopasty is controversial. This study examined the TAPSE suitability in patients with previous tricuspid valve annuloplasty using right ventricular fractional area change (RVFAC) as reference method.
  
  
  METHODS
  We retrospectively analyzed 53 patients who underwent tricuspid valve annuloplasty at our hospital between 2013 and 2016. TAPSE and RVFAC were obtained in preoperative and postoperative periods using standard methodology.
  
  
  RESULTS
  Mean age was 68±12years and 34 patients (64.1%) were women. TAPSE decreased significantly after surgery in comparison with pre-surgical values (17±4.2 Vs 12.9±4.1mm, p<0.001). On the contrary, RVFAC did not change significantly after surgery (37±9.2 Vs 36.2.9, p=0.25). The correlation between RVFAC and TAPSE was better in the preoperative (r=0.63, p<0.0001) than in the postoperative period (r=0.38, P=0.005). Good intra- and interobserver agreement for TAPSE and RVFAC was obtained, with intraclass correlation coefficients of 0.97 and 0.92 for TAPSE; and 0.90 and 0.85 for RVFAC, respectively.
  
  
  CONCLUSIONS
  These findings suggest that TAPSE is not suitable after tricuspid valve annuloplasty and it leads to an underestimation of RV systolic function. It seems to be appropriate to rely on echocardiographic parameters of global RV function such as RVFAC in this context.
authors: Cardiovascular Institute, San Carlos University Hospital, Madrid, Spain. Electronic address: albertutor@hotmail.com.
authors: Jose Alberto
authors: JA
authors: de Agustin
authors: Cardiovascular Institute, San Carlos University Hospital, Madrid, Spain.
authors: Pedro
authors: P
authors: Martinez-Losas
authors: Cardiovascular Institute, San Carlos University Hospital, Madrid, Spain.
authors: Jose Juan Gomez
authors: JJG
authors: de Diego
authors: Cardiovascular Institute, San Carlos University Hospital, Madrid, Spain.
authors: Patricia
authors: P
authors: Mahia
authors: Cardiovascular Institute, San Carlos University Hospital, Madrid, Spain.
authors: Pedro
authors: P
authors: Marcos-Alberca
authors: Cardiovascular Institute, San Carlos University Hospital, Madrid, Spain.
authors: Ivan Javier
authors: IJ
authors: Nuñez-Gil
authors: Cardiovascular Institute, San Carlos University Hospital, Madrid, Spain.
authors: Jose Luis
authors: JL
authors: Rodrigo
authors: Cardiovascular Institute, San Carlos University Hospital, Madrid, Spain.
authors: Maria
authors: M
authors: Luaces
authors: Cardiovascular Institute, San Carlos University Hospital, Madrid, Spain.
authors: Fabian
authors: F
authors: Islas
authors: Cardiovascular Institute, San Carlos University Hospital, Madrid, Spain.
authors: Miguel Angel
authors: MA
authors: Garcia-Fernandez
authors: Cardiovascular Institute, San Carlos University Hospital, Madrid, Spain.
authors: Carlos
authors: C
authors: Macaya
authors: Cardiovascular Institute, San Carlos University Hospital, Madrid, Spain.
authors: Leopoldo Perez
authors: LP
authors: de Isla
mesh_terms: D000368:Aged; D058385:Cardiac Valve Annuloplasty; D004452:Echocardiography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D011184:Postoperative Period; D012189:Retrospective Studies; D013599:Systole; D014261:Tricuspid Valve / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D014262:Tricuspid Valve Insufficiency / Q000175:diagnosis / Q000601:surgery*; D016278:Ventricular Function, Right / Q000502:physiology*
keywords: Right ventricular function; Tricuspid annular plane systolic excursion; Tricuspid annulopasty