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The association between TAPSE and right atrial contractile strain

Sena Sert1, Lale Dinç Asarcıklı1, Fatih Mehmet Yılmaz1, Levent Pay1, Aycan Zencirci Esen1, Aysel Yağmur1, Barış Güngör1, Özlem Yıldırımtürk1
DOI: 10.33963/KP.a2022.0273
Affiliations
  1. Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey

open access

Online first
Original article
Published online: 2022-11-30

Abstract

BACKGROUND: In the descending arm of tricuspid annular plane systolic excursion (TAPSE) there is a notch formation which corresponds to the contractile phase of the atrial strain curve. Theoretically, this notch formation stands for atrial contraction.

AIMS: We aim to characterize the notch formation on the TAPSE, the predictors of its existence, its relationship with the right ventricle and right atrial strain (RAS) parameters.

METHODS: Retrospectively selected 240 patients were investigated for the determinants of the notch formation on TAPSE and the relation between RAS and TAPSE. RAS was analyzed using 2D speckle tracking in a dedicated mode for atrial analysis and reported separately for the reservoir, conduit, and contractile phases.

RESULTS: 71.7% (n = 172) of patients had the notch formation on the TAPSE and 70.4% (n = 169) had a normal value of right atrial contractile strain (RASct). Most of the patients with a notch formation also had preserved RASct (95.9%; P <0.001). In multivariable analysis, RASct (odds ratio [OR], 1.45; 95% confidence interval [CI]: 1.13­­‒1.77; P = 0.020) remained significant with the notch formation. Receiver operator characteristic (ROC) analysis demonstrated that a RASct of ‒19% was found as a cut-off for presence of notch formation. ROC area was 0.897 (95% CI 0.844–0.951; P <0.001).

CONCLUSIONS: The changes in TAPSE configuration represents the changes in atrial contractile phase. The descending arm of the TAPSE indicates the RASct as whether it is preserved or not. The notch formation persists if the RASct is above ‒19%. So, an easier, more applicable, and more effortless tool TAPSE can be used as an indicator of atrial contractile phase by its configuration in daily routine.

Abstract

BACKGROUND: In the descending arm of tricuspid annular plane systolic excursion (TAPSE) there is a notch formation which corresponds to the contractile phase of the atrial strain curve. Theoretically, this notch formation stands for atrial contraction.

AIMS: We aim to characterize the notch formation on the TAPSE, the predictors of its existence, its relationship with the right ventricle and right atrial strain (RAS) parameters.

METHODS: Retrospectively selected 240 patients were investigated for the determinants of the notch formation on TAPSE and the relation between RAS and TAPSE. RAS was analyzed using 2D speckle tracking in a dedicated mode for atrial analysis and reported separately for the reservoir, conduit, and contractile phases.

RESULTS: 71.7% (n = 172) of patients had the notch formation on the TAPSE and 70.4% (n = 169) had a normal value of right atrial contractile strain (RASct). Most of the patients with a notch formation also had preserved RASct (95.9%; P <0.001). In multivariable analysis, RASct (odds ratio [OR], 1.45; 95% confidence interval [CI]: 1.13­­‒1.77; P = 0.020) remained significant with the notch formation. Receiver operator characteristic (ROC) analysis demonstrated that a RASct of ‒19% was found as a cut-off for presence of notch formation. ROC area was 0.897 (95% CI 0.844–0.951; P <0.001).

CONCLUSIONS: The changes in TAPSE configuration represents the changes in atrial contractile phase. The descending arm of the TAPSE indicates the RASct as whether it is preserved or not. The notch formation persists if the RASct is above ‒19%. So, an easier, more applicable, and more effortless tool TAPSE can be used as an indicator of atrial contractile phase by its configuration in daily routine.

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Keywords

atrial contractile strain, right atrial strain, tricuspid annular plane systolic excursion

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Title

The association between TAPSE and right atrial contractile strain

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Online first

Article type

Original article

Published online

2022-11-30

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44

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41

DOI

10.33963/KP.a2022.0273

Keywords

atrial contractile strain
right atrial strain
tricuspid annular plane systolic excursion

Authors

Sena Sert
Lale Dinç Asarcıklı
Fatih Mehmet Yılmaz
Levent Pay
Aycan Zencirci Esen
Aysel Yağmur
Barış Güngör
Özlem Yıldırımtürk

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