Premium
Improvement in Tricuspid Annular Plane Systolic Excursion with Pulmonary Hypertension Therapy in Pediatric Patients
Author(s) -
Bano Maria,
Kanaan Usama B.,
Ehrlich Alexandra C.,
McCracken Courtney,
Morrow Gemma,
Oster Matthew E.,
Sachdeva Ritu
Publication year - 2015
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.12835
Subject(s) - medicine , cardiology , pulmonary hypertension , tricuspid valve , ventricular function , tricuspid insufficiency
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. Conclusion 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.