• Int J Cardiovasc Imaging · Sep 2017

    Comparative Study

    Agreement of tricuspid annular systolic excursion measurement between transthoracic and transesophageal echocardiography in the perioperative setting.

    • Flo Forner Anna A Department of Anesthesiology and Intensive Care Medicine, Heart Center Leipzig, Struempellstrasse 39, 04289, Leipzig, Germany. anna.floforner@helios-kli, Elham Hasheminejad, Sergi Sabate, Michael A Ackermann, Edwin W Turton, and Joerg Ender.
    • Department of Anesthesiology and Intensive Care Medicine, Heart Center Leipzig, Struempellstrasse 39, 04289, Leipzig, Germany. anna.floforner@helios-kliniken.de.
    • Int J Cardiovasc Imaging. 2017 Sep 1; 33 (9): 1385-1394.

    ObjectiveThe aim of our study was to evaluate the level of agreement between tricuspid annular plane systolic excursion (TAPSE) measured by transthoracic echocardiography (TTE) and TAPSE measured using transesophageal echocardiography (TEE) in anesthetized patients.Materials And MethodsThirty patients scheduled for elective cardiac surgery were prospectively studied. Shortly after induction of anesthesia before the operation, TAPSE was measured by TTE using M-mode in apical 4chamber view (4CH) and by TEE in six different views: using 2D echocardiography in midesophageal (ME) 4CH view, using M-mode in deep transgastric right ventricle (dTG RV) view at 0° and dTG RV longaxis view (LAX) as well as using anatomical M-mode (AM-mode) in ME 4CH, dTG RV at 0° and dTG RV LAX views.ResultsBland-Altman analysis showed a good agreement for TAPSE measured using M-mode in TTE and using AM-mode in TEE in the ME 4CH and dTG RV at 0° views (-2.5 ± 18 and -2.2 ± 14% respectively). The agreement between TAPSE measured in TTE and TEE using 2D in ME 4CH, using M-mode in dT GRV 0° and using M-mode and AM-mode in dTG RV LAX view showed a significant systematic underestimation of the measurements (-8.8 ± 21, -8.8 ± 24, -17.8 ± 28 and -6.4 ± 20%).ConclusionOur study showed that the right ventricular function can be accurately and precisely estimated using TAPSE measurement by TEE in the midesophageal four chamber and deep transgastric right ventricle view at 0° using anatomical M-mode.

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