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Tricuspid annular plane systolic excursion as a marker of right ventricular dysfunction in pediatric patients with dilated cardiomyopathy
Author(s) -
McLaughlin Ericka S.,
Travers Curtis,
Border William L.,
Deshpande Shriprasad,
Sachdeva Ritu
Publication year - 2017
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.13416
Subject(s) - medicine , cardiology , ejection fraction , dilated cardiomyopathy , clinical endpoint , cardiomyopathy , heart failure , randomized controlled trial
Background Right ventricular systolic dysfunction ( RVSD ) is a predictor of outcomes in dilated cardiomyopathy ( DCM ) in adults, but little is known in children. Tricuspid annular plane systolic excursion ( TAPSE ) has emerged as a reliable tool to assess RVSD . We sought to determine the prevalence and prognostic significance of RVSD using TAPSE in children with DCM . Methods The first echocardiogram at the time of diagnosis with DCM was analyzed to obtain left ventricular ejection fraction ( LVEF ) and 2D TAPSE . RVSD was defined as TAPSE age‐based z‐score ≤−2. The association of a composite primary endpoint including death, mechanical support, or transplantation with RVSD was analyzed using LVEF and TAPSE . Results Of the 96 patients, RVSD was noted in 84 (88%). During a median follow‐up of 17.5 months ( IQR 1.4, 76.2), the primary endpoints were reached in 59%. There was a lower LVEF in patients with RVSD ( P =.016). Moderate or severe RVSD showed a significant association with the composite primary endpoint (unadjusted OR 2.7 [95% CI : 1.15–6.33], P =.023). Kaplan‐Meier analysis showed that the event‐free survival was significantly lower in patients with LVEF ≤30% and TAPSE z‐score ≤−4. Conclusion Children with DCM have a high prevalence of RVSD based on reduced TAPSE , and those with moderate or severe RVSD have worse clinical outcomes.