tricuspid annular plane systolic excursion is reflective of biventricular function in critically ill...

MEETING ABSTRACT Open Access Tricuspid annular plane systolic excursion is reflective of biventricular function in critically ill patients Ratender Singh * , Sudeep Kumar, Sreevatsa Nadig, Arvind Baronia From 9th WINFOCUS World Congress on Ultrasound in Emergency and Critical Care Hong Kong. 6-9 November 2013 Background Tricuspid annular plane systolic excursion (TAPSE) is an easily measureable,fast and reproducible echocardiographic parameter which gives relevant information about biventricular cardiac function. Objective To explore the utility of tricuspid annular plane systolic excursion (TAPSE) for biventricular function assessment in critically ill ICU patients at admission. Design Prospective observational study. Setting A 12-bed medical-surgical critical care unit. Patients and methods 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. Results TAPSE, right ventricle (RV) fractional area change (FAC), the left ventricular ejection fraction (LVEF), were mea- sured 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). Conclusions 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. Published: 31 January 2014 doi:10.1186/2036-7902-6-S1-A14 Cite this article as: Singh et al.: Tricuspid annular plane systolic excursion is reflective of biventricular function in critically ill patients. Critical Ultrasound Journal 2014 6(Suppl 1):A14. SGPGIMS, Department of Critical Care Medicine, Lucknow, India Singh et al. Critical Ultrasound Journal 2014, 6(Suppl 1):A14 http://www.criticalultrasoundjournal.com/content/6/S1/A14 © 2014 Singh et al; licensee Spinger. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/ publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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Page 1: Tricuspid annular plane systolic excursion is reflective of biventricular function in critically ill patients

MEETING ABSTRACT Open Access

Tricuspid annular plane systolic excursion isreflective of biventricular function in criticallyill patientsRatender Singh*, Sudeep Kumar, Sreevatsa Nadig, Arvind Baronia

From 9th WINFOCUS World Congress on Ultrasound in Emergency and Critical CareHong Kong. 6-9 November 2013

BackgroundTricuspid annular plane systolic excursion (TAPSE) isan easily measureable,fast and reproducible echocardio-graphic parameter which gives relevant informationabout biventricular cardiac function.

ObjectiveTo explore the utility of tricuspid annular plane systolicexcursion (TAPSE) for biventricular function assessmentin critically ill ICU patients at admission.

DesignProspective observational study.

SettingA 12-bed medical-surgical critical care unit.

Patients and methodsHundred and one patients admitted to the ICU for sepsis,septic shock, acute cardio respiratory failure or otherorgan supportivecare. A trained cardiologist conductedtransthoracic echocardiography within 48 hours ofadmission to ICU. Echocardiographic parameters of bothright and left heart along with demographic, prognosis,hemodynamic, ventilator, and laboratory parameterswererecorded.

ResultsTAPSE, right ventricle (RV) fractional area change (FAC),the left ventricular ejection fraction (LVEF), were mea-sured using Doppler echocardiography. Mean age andTAPSE 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 atannulus (left) (N = 98; r = 0.287; p = 0.004), LVEF(N = 97;r = 0.248; p = 0.014). Also observed was a negative correla-tion was with tissue doppler myocardial performanceindex (left) (N = 74; r = -0.226; p = 0.05). On logisticregression analysis TAPSE showed a significant impact onboth 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).

ConclusionsTAPSE is reflective of biventricular function at baseline incritically ill ICU patients. Its potential as a hemodynamicmonitoring tool needs further exploration in criticalillness.

Published: 31 January 2014

doi:10.1186/2036-7902-6-S1-A14Cite this article as: Singh et al.: Tricuspid annular plane systolicexcursion is reflective of biventricular function in critically ill patients.Critical Ultrasound Journal 2014 6(Suppl 1):A14.

SGPGIMS, Department of Critical Care Medicine, Lucknow, India

Singh et al. Critical Ultrasound Journal 2014, 6(Suppl 1):A14http://www.criticalultrasoundjournal.com/content/6/S1/A14

© 2014 Singh et al; licensee Spinger. This is an Open Access article distributed under the terms of the Creative Commons AttributionLicense (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium,provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

http://creativecommons.org/licenses/by/2.0

http://creativecommons.org/publicdomain/zero/1.0/

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