Goldberg David J, French Benjamin, Szwast Anita L, McBride Michael G, Paridon Stephen M, Rychik Jack, Mercer-Rosa Laura
The Cardiac Center, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Echocardiography. 2016 Dec;33(12):1897-1902. doi: 10.1111/echo.13348. Epub 2016 Sep 5.
Tricuspid annular plane systolic excursion (TAPSE) is a reproducible measure of right ventricular systolic function. We sought to determine the reliability of TAPSE measurements, to evaluate TAPSE in patients with hypoplastic left heart syndrome (HLHS) relative to normal values, and to correlate values of TAPSE with measures of exercise performance.
Tricuspid annular plane systolic excursion measurements were performed off-line in the cohort of patients with single right ventricle anatomy who had been enrolled in the Sildenafil After Fontan Operation clinical trial. These values were converted to z-scores using age-specific means and standard deviations according to published reference values. Reproducibility of measurements was assessed using the coefficient of variation between two readers. Comparisons between echo measurements and exercise outcomes were assessed using Pearson correlation coefficients.
Forty-four echocardiograms from 11 subjects were included in this analysis. The median age of included subjects was 13 years (range 12-17). The coefficient of variation for TAPSE measurements was 5.0%. TAPSE was significantly diminished relative to reference values, with a median z-score of -7.6. TAPSE values correlated with both maximal oxygen consumption (R=.64; P=.033) and oxygen consumption at the anaerobic threshold (R=.73, P=.017).
In this small sample of children with HLHS, TAPSE was reproducible, substantially lower than reference values, and correlated well with measures of exercise performance. Further studies are needed to evaluate these findings in a larger cohort and in a longitudinal manner.
三尖瓣环平面收缩期位移（TAPSE）是右心室收缩功能的一项可重复测量指标。我们旨在确定TAPSE测量的可靠性，评估左心发育不全综合征（HLHS）患者的TAPSE相对于正常值的情况，并将TAPSE值与运动表现指标进行关联。
对参加了Fontan手术后使用西地那非的临床试验的单右心室解剖结构患者队列进行离线三尖瓣环平面收缩期位移测量。根据已发表的参考值，使用特定年龄的均值和标准差将这些值转换为z分数。使用两位读者之间的变异系数评估测量的可重复性。使用Pearson相关系数评估超声心动图测量结果与运动结果之间的比较。
本分析纳入了11名受试者的44份超声心动图。纳入受试者的中位年龄为13岁（范围12 - 17岁）。TAPSE测量的变异系数为5.0%。相对于参考值，TAPSE显著降低，中位z分数为 - 7.6。TAPSE值与最大耗氧量（R = 0.64；P = 0.033）和无氧阈值时的耗氧量均相关（R = 0.73，P = 0.017）。
在这个小样本的HLHS儿童中，TAPSE是可重复的，显著低于参考值，并且与运动表现指标相关性良好。需要进一步研究以更大队列和纵向方式评估这些发现。
