P881Comparison of echocardiographic and computed tomographic assessment of tricuspid annular plane systolic excursion (TAPSE)


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Abstract

Purpose: TAPSE is widely used for the assessment of right ventricular function using trans-thoracic echocardiography (TTE). Measurement of TAPSE using ECG-triggered cardiac computed tomography (CCT) has been less studied, but it is desirable to evaluate right ventricular function if a CCT is performed. The aim of the study is to assess the relation and diagnostic accuracy between CCT and TTE.Methods: We studied 55 adults (42M/13F, mean age: 52±12 years) referred for CCT and TTE, based on clinical indication, mainly before atrial fibrillation ablation and trans-catheter aortic valve implantation procedures. Demographic data, cardiac rhythm and TAPSE measurement by TTE and CCT were collected. CCT was carried out on a Siemens Somatom Definition (dual source). Image data over the complete heart was acquired with retrospective gating covering a cardiac cycle (R to R wave in 5% increments). TAPSE was calculated from images in a cine loop in the four chamber view. Echocardiographic TAPSE was acquired similarly or by M-mode.Results: Mean TAPSE was 1.86±0.41cm for TTE and 1.80±0.53cm for CCT. There was a good correlation between CCT and TTE measurement, (r=0.69, p<0.01). This correlation became stronger for the patients in sinus rhythm (r=0.77, p<0.01) compared with patients in atrial fibrillation (r=0.59, p<0,01). Bland-Altman analysis showed strong agreement and minimally lower values of TAPSE using CCT, (bias±SD: 0.06±0.38cm, 95% CI: -0.05 – 0.16).Conclusions: Assessment of right ventricular systolic function using tricuspid annular plane systolic excursion measured with ECG-triggered cardiac computed tomography agrees reasonably well with echocardiographic measurements, indicating its potential clinical usefulness, especially in patients with sinus rhythm.

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