Prevalence of, associations with, and prognostic value of tricuspid annular plane systolic excursion (TAPSE) among out-patients referred for the evaluation of heart failure.

Abstract

BACKGROUND:

Prevalence, predictors, and prognostic value of right ventricular (RV) function measured by the tricuspid annular plane systolic excursion (TAPSE) in patients with chronic heart failure (CHF) symptoms with a broad range of left ventricular ejection fraction (LVEF) are unknown.

METHODS AND RESULTS:

Of 1,547 patients, mean (±SD) age was 71 ± 11 years, 48% were women, median (interquartile range [IQR]) TAPSE was 18.5 (14.0-22.7) mm, mean LVEF was 47 ± 16%, 47% had LVEF ≤45% and 67% were diagnosed with CHF, defined as systolic (S-HF) if LVEF was ≤45% and as heart failure with preserved ejection fraction (HFPEF) if LVEF was >45% and treated with a loop diuretic. During a median (IQR) follow-up of 63 (41-75) months, mortality was 34%. In multivariable analysis, increasing age, N-terminal pro-B-type natriuretic peptide (NT-proBNP), New York Heart Association functional class, right atrial volume index, and transtricuspid pressure gradient; lower TAPSE, diastolic blood pressure, and hemoglobin; and atrial fibrillation (AF) or COPD were associated with an adverse prognosis. Receiver operating characteristic curve analysis identified a TAPSE of 15.9 mm as the best prognostic threshold (P = .0001); 47% of S-HF and 20% of HFPEF had a TAPSE of <15.9 mm. The main associations with a TAPSE <15.9 mm were higher NT-proBNP, presence of atrial fibrillation and presence of LV systolic dysfunction.

CONCLUSIONS:

In patients with CHF, low values for TAPSE are common, especially in those with reduced LVEF. TAPSE, unlike LVEF, was an independent predictor of outcome.

• Authors: Thibaud Damy, Anna Kallvikbacka-Bennett, Kevin Goode, Olga Khaleva, Christian Lewinter, James Hobkirk, Nikolay P Nikitin, Jean-Luc Dubois-Randé, Luc Hittinger, Andrew L Clark, John G F Cleland
• Journal: Journal of cardiac failure (J Card Fail) Vol. 18 Issue 3 Pg. 216-25 (Mar 2012) ISSN: 1532-8414 [Electronic] United States
• PMID: 22385942 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2012 Elsevier Inc. All rights reserved.

Topics

• Aged
• Aged, 80 and over
• Female
• Follow-Up Studies
• Heart Failure (diagnosis, mortality, physiopathology)
• Humans
• Male
• Middle Aged
• Prevalence
• Prognosis
• Stroke Volume
• Survival Rate
• Tricuspid Valve
• Ventricular Function, Right