Feasibility and accuracy of tricuspid annular displacement assessed by speckle tracking echocardiography and Doppler tissue imaging.

BACKGROUND

Tricuspid annular plane systolic excursion (TAPSE) is a recommended quantitative measure of right ventricular (RV) longitudinal function assessed by M-mode echocardiography. Offline alternatives are desirable when TAPSE is unavailable. This study aimed to assess the feasibility, reliability, and agreement between retrospectively obtained measures of tricuspid annular displacement using Doppler tissue imaging (TAD ) and speckle tracking echocardiography (TAD ) compared with reference TAPSE.

METHODS

Consecutive subjects referred for evaluation of heart failure were enrolled. Subjects in atrial fibrillation, significant valvular disease, or with poor image quality were excluded. TAPSE was measured during the examination using M-mode. TAD was measured as the maximal longitudinal displacement of the RV basal segment in systole using speckle strain imaging. TAD was derived offline from color-DTI superimposed grayscale images.

RESULTS

107 subjects (age 60 ± 16; 48% female) were analyzed. Both TAD and TAD demonstrated good feasibility and excellent intra- and inter-observer concordances. Although both measures demonstrated strong association with TAPSE, TAD showcased lower specificity to identify RV dysfunction and higher false positives. Bland-Altman analysis revealed a tendency of TAD to underestimate TAPSE (bias = 1.40; SD = 2.74 mm) as compared with TAD (bias = 0.27; SD = 2.30mm). Wide limits of agreement were observed for both methods.

CONCLUSIONS

TAD and TAD provide reproducible and feasible quantification of RV function. However, TAD significantly underestimates TAPSE limiting the interchangeability of these modalities.