Intensive Care Medicine

, 33:2143

Relationship between the tricuspid annular plane systolic excursion and right and left ventricular function in critically ill patients

  • Bouchra Lamia
  • Jean-Louis Teboul
  • Xavier Monnet
  • Christian Richard
  • Denis Chemla
Original

DOI: 10.1007/s00134-007-0881-y

Cite this article as:
Lamia, B., Teboul, JL., Monnet, X. et al. Intensive Care Med (2007) 33: 2143. doi:10.1007/s00134-007-0881-y

Abstract

Objective

Echocardiographic recording of the tricuspid annular plane systolic excursion (TAPSE) has been recommended for assessing right ventricular function in cardiac patients. The ability of TAPSE to reflect right ventricular function at baseline and to monitor acute changes in right ventricular function was tested in critically ill patients.

Design

Prospective study.

Setting

A 24-bed medical intensive care unit.

Patients

Eighty-six patients admitted for acute respiratory failure, circulatory failure, or coma.

Interventions

In 40 patients, the examination was repeated after volume expansion (n = 15), passive leg raising (n = 5), or dobutamine infusion (n = 20).

Measurements and results

The right ventricular fractional area change, TAPSE, the left ventricular ejection fraction, and the ratio of right to left ventricular end-diastolic area were measured using Doppler echocardiography. In the overall population, TAPSE (19 ± 5 mm) was positively related to left ventricular ejection fraction (r2 = 0.31, p < 0.001) and right ventricular fractional area change and was negatively related to age and to the ratio of right to left ventricular end-diastolic area. Multivariate analysis indicated that only left ventricular ejection fraction and agewere independently related toTAPSE (multiple r2 = 0.36, p < 0.001). Following dynamic interventions, the changes in TAPSE were linearly related to changes in left ventricular ejection fraction (r2 = 0.65, p < 0.01) but notto changes in the right ventricular fractional area change.

Conclusions

Unexpectedly, TAPSE was more strongly related to left ventricular ejection fraction than to indices of right ventricular function in critically ill patients. The potential interest of TAPSE as a dynamic marker of left ventricular systolic function deserves further study.

Keywords

Right ventricular function Left ventricular function Echocardiography Tricuspid 

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Bouchra Lamia
    • 1
  • Jean-Louis Teboul
    • 1
    • 2
  • Xavier Monnet
    • 1
    • 2
  • Christian Richard
    • 1
    • 2
  • Denis Chemla
    • 2
    • 3
    • 4
  1. 1.Service de Réanimation MédicaleAP-HPLe Kremlin-BicêtreFrance
  2. 2.Equipe d’Accueil EA4046Université Paris-SudLe Kremlin-BicêtreFrance
  3. 3.Service d’Explorations Fonctionnelles et de PhysiologieAP-HPLe Kremlin-BicêtreFrance
  4. 4.Service d’explorations fonctionnelles-EA4046, Centre Hospitalo-Universitaire de BicêtreUniversité Paris Sud, 11Le Kremlin-BicetreFrance

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