• Emily E Naoum, Patrick T Schofield, Tao Shen, Michael N Andrawes, and Alexander S Kuo.
• Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA. Electronic address: eminaoum@gmail.com.
• J. Cardiothorac. Vasc. Anesth. 2019 Mar 1; 33 (3): 717-724.

ObjectiveTo assess the agreement between 2-dimensional tricuspid annular plane systolic excursion (2D-TAPSE), 2D-TAPSE-apex, and 2D speckle tracking echocardiography (STE-TAPSE) in a cross-section of routine cardiac surgery patients.DesignRetrospective, observational study.SettingTertiary, academic referral hospital.ParticipantsPatients undergoing elective cardiac surgery with intraoperative transesophageal echocardiography (TEE) imaging.InterventionsTEE imaging was reviewed and evaluated for the following three different measurements of transthoracic echocardiography-TAPSE surrogates: 2D-TAPSE, 2D-TAPSE-apex, and STE-TAPSE. Statistical analyses, including 2-sample t tests, linear regression, and agreement using the Bland-Altman methods, were performed.Measurements And Main ResultsModest correlation was demonstrated between STE-TAPSE and 2D-TAPSE (R2 = 0.37; p < 0.001) and between STE-TAPSE and 2D-TAPSE-apex (R2 = 0.34; p < 0.001). There was good correlation between 2D-TAPSE and 2D-TAPSE-apex (R2 = 0.77, p < 0.001). The Bland-Altman analysis between these methods showed minimal bias: STE-TAPSE and 2D-TAPSE 0.84 mm, STE-TAPSE and 2D-TAPSE-apex 0.14 mm, and 2D-TAPSE and 2D-TAPSE-apex 0.98 mm. However, the agreement was poor, with 95% limits of agreement of -10.67 to 8.99 mm, -10.67 to 10.96 mm, and -4.91 to 6.88 mm, respectively.ConclusionsCorrelation and minimal bias were found between the several proposed TEE surrogates of transthoracic echocardiography-TAPSE; however, there was poor agreement. Therefore, these surrogates are not interchangeable, and each method needs to be separately validated for clinical use to relevant perioperative outcomes.Copyright © 2018 Elsevier Inc. All rights reserved.

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