Clinical InvestigationEchocardiographic Reference Values in Children and AdultsRight Ventricular Function in Infants, Children and Adolescents: Reference Values of the Tricuspid Annular Plane Systolic Excursion (TAPSE) in 640 Healthy Patients and Calculation of z Score Values
Section snippets
Patient Population
The patients were selected from healthy individuals referred to our cardiology service for evaluation of heart murmurs or family histories of heart disease. The study group consisted of 640 pediatric patients (348 male, 292 female) with normal echocardiographic results. The study group encompassed neonates to adolescents (age range, 1 day to 18 years; BSA range, 0.12-2.25 m2), including 41 neonates and 87 infants. For the purposes of the study, only echocardiograms with official readings of
Results
TAPSE, age, and BSA were strongly correlated: Spearman's rank correlation coefficients were 0.93 for age and TAPSE, 0.97 for age and BSA, and 0.93 for BSA and TAPSE. Adjusting for the strong correlation between age and TAPSE, the partial correlation between BSA and TAPSE was 0.31. This shows a minor additional impact of BSA for the TAPSE values. TAPSE ranged from a mean of 0.91 cm (z score ± 3, 0.56-1.26 cm) in neonates to 2.47 cm (z score ± 3, 1.84-3.10 cm) in 18-year-olds (Table 1). TAPSE
Discussion
Our intention was to assess a method that can be easily applied but is reliable to provide a quick assessment of RV function. Recent publications have shown that TAPSE measurement is more reproducible than other echocardiographic indices of RV function5, 10 and has high specificity and negative predictive power for detecting abnormal RV systolic function in adults.3, 13, 14 TAPSE is much easier to measure than RV ejection fraction in clinical practice. This parameter can therefore be considered
Conclusion
We have established normal reference values of TAPSE in the pediatric age group with respect to age and BSA that could serve as a reference database for ready application in pediatric patients with CHD and acquired RV and LV dysfunction. In the future, TAPSE measurements may be included in the battery of echocardiographic markers in patients with CHD, especially in those with expected decreased RV function.
References (23)
- et al.
Right ventricular dysfunction is a major predictor of outcome in patients with moderate to severe mitral regurgitation and left ventricular dysfunction
Am Heart J
(2007) - et al.
Prognostic usefulness of the tricuspid annular plane systolic excursion in patients with congestive heart failure secondary to idiopathic or ischemic dilated cardiomyopathy
Am J Cardiol
(2000) - et al.
Recommendations for chamber quantifications: a report from the American Society of Echocardiography's Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology
J Am Soc Echocardiogr
(2005) - et al.
The relation between quantitative right ventricular ejection fraction and indices of tricuspid annular motion and myocardial performance
J Am Soc Echocardiogr
(2004) - et al.
Assessment of right ventricular function using two-dimensional echocardiography
Am Heart J
(1984) - et al.
Right ventricular systolic function is not the sole determinant of tricuspid annular motion
Am J Cardiol
(2006) - et al.
Usefulness of echocardiographic determined tricuspid regurgitation in predicting event-free survival in severe heart failure secondary to idiopathic-dilated cardiomyopathy or to ischemic cardiomyopathy
Am J Cardiol
(1998) - et al.
Normal regional right ventricular function and its change with age: a Doppler myocardial imaging study
J Am Soc Echocardiogr
(2000) - et al.
Longitudinal motion of the atrioventricular annuli in children: reference values, growth related changes, and effects of right ventricular volume and pressure overload
J Am Soc Echocardiogr
(2002) Right ventricular function
Cardiol Clin
(2002)
Right ventricular TEI index in children: effect of method, age, body surface area, and heart rate
J Am Soc Echocardiogr
Cited by (321)
Targeted Neonatal Echocardiography in the Management of Neonatal Pulmonary Hypertension
2024, Clinics in PerinatologyGuidelines for Performing a Comprehensive Pediatric Transthoracic Echocardiogram: Recommendations From the American Society of Echocardiography
2024, Journal of the American Society of EchocardiographyTricuspid Annular Plane Systolic Excursion (TAPSE) for the Assessment of Right Ventricular Function in Adult and Pediatric Cardiac Surgery: Modified Two-dimensional and M-mode TAPSE by Transesophageal Echocardiography Compared to M-mode TAPSE by Transthoracic Echocardiography
2024, Journal of Cardiothoracic and Vascular AnesthesiaThe need to develop reference parameters of quantitative echocardiography in healthy children of Uzbek nationality
2023, Progress in Pediatric CardiologyContraction Patterns of Post-Fontan Single Right Ventricle Versus Normal Left and Right Ventricles in Children: Insights From Principal Strain Analysis
2023, Journal of the American Society of Echocardiography