• Jose Alberto de Agustin, Pedro Martinez-Losas, de Diego Jose Juan Gomez JJG Cardiovascular Institute, San Carlos University Hospital, Madrid, Spain., Patricia Mahia, Pedro Marcos-Alberca, Ivan Javier Nuñez-Gil, Jose Luis Rodrigo, Maria Luaces, Fabian Islas, Miguel Angel Garcia-Fernandez, Carlos Macaya, and de Isla Leopoldo Perez LP Cardiovascular Institute, San Carlos University Hospital, Madrid, Spain..
• Cardiovascular Institute, San Carlos University Hospital, Madrid, Spain. Electronic address: albertutor@hotmail.com.
• Int. J. Cardiol. 2016 Nov 15; 223: 713-716.

ObjetivesThe clinical and prognostic usefulness of tricuspid annular plane systolic excursion (TAPSE) is well established. However, the ability of TAPSE to assess right ventricular (RV) function in patients with previous tricuspid valve annulopasty is controversial. This study examined the TAPSE suitability in patients with previous tricuspid valve annuloplasty using right ventricular fractional area change (RVFAC) as reference method.MethodsWe retrospectively analyzed 53 patients who underwent tricuspid valve annuloplasty at our hospital between 2013 and 2016. TAPSE and RVFAC were obtained in preoperative and postoperative periods using standard methodology.ResultsMean age was 68±12years and 34 patients (64.1%) were women. TAPSE decreased significantly after surgery in comparison with pre-surgical values (17±4.2 Vs 12.9±4.1mm, p<0.001). On the contrary, RVFAC did not change significantly after surgery (37±9.2 Vs 36.2.9, p=0.25). The correlation between RVFAC and TAPSE was better in the preoperative (r=0.63, p<0.0001) than in the postoperative period (r=0.38, P=0.005). Good intra- and interobserver agreement for TAPSE and RVFAC was obtained, with intraclass correlation coefficients of 0.97 and 0.92 for TAPSE; and 0.90 and 0.85 for RVFAC, respectively.ConclusionsThese findings suggest that TAPSE is not suitable after tricuspid valve annuloplasty and it leads to an underestimation of RV systolic function. It seems to be appropriate to rely on echocardiographic parameters of global RV function such as RVFAC in this context.Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

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