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Feasibility and accuracy of tricuspid annular displacement assessed by speckle tracking echocardiography and Doppler tissue imaging
Author(s) -
Tan Yuan,
Manouras Aristomenis,
Lund Lars H.,
Venkateshvaran Ashwin
Publication year - 2019
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.14500
Subject(s) - medicine , cardiology , speckle tracking echocardiography , doppler imaging , cardiac imaging , intraclass correlation , atrial fibrillation , kappa , radiology , nuclear medicine , heart failure , ejection fraction , diastole , blood pressure , clinical psychology , linguistics , philosophy , psychometrics
Background Tricuspid annular plane systolic excursion (TAPSE) is a recommended quantitative measure of right ventricular (RV) longitudinal function assessed by M‐mode echocardiography. Offline alternatives are desirable when TAPSE is unavailable. This study aimed to assess the feasibility, reliability, and agreement between retrospectively obtained measures of tricuspid annular displacement using Doppler tissue imaging (TAD DTI ) and speckle tracking echocardiography (TAD STE ) compared with reference TAPSE. Methods Consecutive subjects referred for evaluation of heart failure were enrolled. Subjects in atrial fibrillation, significant valvular disease, or with poor image quality were excluded. TAPSE was measured during the examination using M‐mode. TAD STE was measured as the maximal longitudinal displacement of the RV basal segment in systole using speckle strain imaging. TAD DTI was derived offline from color‐DTI superimposed grayscale images. Results 107 subjects (age 60 ± 16; 48% female) were analyzed. Both TAD DTI and TAD STE demonstrated good feasibility and excellent intra‐ and inter‐observer concordances. Although both measures demonstrated strong association with TAPSE, TAD DTI showcased lower specificity to identify RV dysfunction and higher false positives. Bland‐Altman analysis revealed a tendency of TAD DTI to underestimate TAPSE (bias = 1.40; SD = 2.74 mm) as compared with TAD STE (bias = 0.27; SD = 2.30mm). Wide limits of agreement were observed for both methods. Conclusions TAD STE and TAD DTI provide reproducible and feasible quantification of RV function. However, TAD DTI significantly underestimates TAPSE limiting the interchangeability of these modalities.