Tricuspid annular plane systolic excursion is reflective of biventricular function in critically ill patients

Tricuspid annular plane systolic excursion (TAPSE) is an easily measureable,fast and reproducible echocardiographic parameter which gives relevant information about biventricular cardiac function.

To explore the utility of tricuspid annular plane systolic excursion (TAPSE) for biventricular function assessment in critically ill ICU patients at admission.

Prospective observational study.

A 12-bed medical-surgical critical care unit.

Hundred and one patients admitted to the ICU for sepsis, septic shock, acute cardio respiratory failure or other organ supportivecare. A trained cardiologist conducted transthoracic echocardiography within 48 hours of admission to ICU. Echocardiographic parameters of both right and left heart along with demographic, prognosis, hemodynamic, ventilator, and laboratory parameters wererecorded.

TAPSE, right ventricle (RV) fractional area change (FAC), the left ventricular ejection fraction (LVEF), were measured using Doppler echocardiography. Mean age and TAPSE of patients was 41.54 ± 16.07 years and 23.09 ± 5.534 mm respectively. Positive correlation of TAPSE was observed with pulsed doppler peak velocity at annulus (right) (N = 95; r = 0.432; p = 0.000), RVFAC (N = 94; r = 0.397; p = 0.000), pulsed doppler peak velocity at annulus (left) (N = 98; r = 0.287; p = 0.004), LVEF(N = 97; r = 0.248; p = 0.014). Also observed was a negative correlation was with tissue doppler myocardial performance index (left) (N = 74; r = -0.226; p = 0.05). On logistic regression analysis TAPSE showed a significant impact on both RVFAC (p = 0.009; Exp (B) = 11.329; 95% C.I = 1.832-70.079) and LVEF (p = 0.040; Exp (B) = 14.154; 95% C.I = 1.127-177.825).

TAPSE is reflective of biventricular function at baseline in critically ill ICU patients. Its potential as a hemodynamic monitoring tool needs further exploration in critical illness.