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Tricuspid annular plane systolic excursion (TAPSE) predicts poor outcome in patients undergoing acute pulmonary embolectomy

INTRODUCTION: Right ventricular failure remains a major cause of mortality during acute pulmonary embolism. Right ventricular function can be assessed with transesophageal echocardiography. However, due to the complex right ventricular anatomy, only a few echocardiographic parameters are reliable an...

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Autores principales: Schmid, Eckhard, Hilberath, Jan N, Blumenstock, Gunnar, Shekar, Prem S, Kling, Steffen, Shernan, Stanton K, Rosenberger, Peter, Nowak-Machen, Martina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: EDIMES Edizioni Internazionali Srl 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4476769/
https://www.ncbi.nlm.nih.gov/pubmed/26157741
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author Schmid, Eckhard
Hilberath, Jan N
Blumenstock, Gunnar
Shekar, Prem S
Kling, Steffen
Shernan, Stanton K
Rosenberger, Peter
Nowak-Machen, Martina
author_facet Schmid, Eckhard
Hilberath, Jan N
Blumenstock, Gunnar
Shekar, Prem S
Kling, Steffen
Shernan, Stanton K
Rosenberger, Peter
Nowak-Machen, Martina
author_sort Schmid, Eckhard
collection PubMed
description INTRODUCTION: Right ventricular failure remains a major cause of mortality during acute pulmonary embolism. Right ventricular function can be assessed with transesophageal echocardiography. However, due to the complex right ventricular anatomy, only a few echocardiographic parameters are reliable and easily obtainable intraoperatively. Tricuspid annular plane systolic excursion is a validated parameter of global right ventricular function. METHODS: Data from 81 patients with acute pulmonary embolus undergoing pulmonary embolectomy were evaluated. Transesophageal echocardiography derived parameters of right ventricular function were obtained and compared to tricuspid annular plane systolic excursion measurements. Patients were then divided into two groups (TAPSE < 18 mm and ≥18 mm).  RESULTS: The patient population consisted of 46 males and 35 females, mean age 61.0 ± 12.9 years. Patients in the TAPSE <18 mm group had significantly larger diastolic (p=0.0015) and systolic (p=0.0031) right ventricular diameters, lower right ventricular fractional area change  (p=0.0065) and greater degrees of tricuspid regurgitation (p=0.0001) compared to patients with TAPSE ≥18 mm. In addition, all patients who needed intraoperative cardiopulmonary resuscitation (11/81) or died intraoperatively (8/81) belonged to the TAPSE <18 mm group. Logistic regression analysis confirmed TAPSE <18 mm as an independent risk factor for intraoperative cardiopulmonary resuscitation and death. CONCLUSIONS: Transesophageal echocardiography derived TAPSE is easily obtainable and correlates well with other standardized parameters of right ventricular function. TAPSE <18 mm is an independent predictor of intraoperative cardiopulmonary resuscitation and death in patients undergoing emergent pulmonary embolectomy.
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spelling pubmed-44767692015-07-08 Tricuspid annular plane systolic excursion (TAPSE) predicts poor outcome in patients undergoing acute pulmonary embolectomy Schmid, Eckhard Hilberath, Jan N Blumenstock, Gunnar Shekar, Prem S Kling, Steffen Shernan, Stanton K Rosenberger, Peter Nowak-Machen, Martina Heart Lung Vessel Research-Article INTRODUCTION: Right ventricular failure remains a major cause of mortality during acute pulmonary embolism. Right ventricular function can be assessed with transesophageal echocardiography. However, due to the complex right ventricular anatomy, only a few echocardiographic parameters are reliable and easily obtainable intraoperatively. Tricuspid annular plane systolic excursion is a validated parameter of global right ventricular function. METHODS: Data from 81 patients with acute pulmonary embolus undergoing pulmonary embolectomy were evaluated. Transesophageal echocardiography derived parameters of right ventricular function were obtained and compared to tricuspid annular plane systolic excursion measurements. Patients were then divided into two groups (TAPSE < 18 mm and ≥18 mm).  RESULTS: The patient population consisted of 46 males and 35 females, mean age 61.0 ± 12.9 years. Patients in the TAPSE <18 mm group had significantly larger diastolic (p=0.0015) and systolic (p=0.0031) right ventricular diameters, lower right ventricular fractional area change  (p=0.0065) and greater degrees of tricuspid regurgitation (p=0.0001) compared to patients with TAPSE ≥18 mm. In addition, all patients who needed intraoperative cardiopulmonary resuscitation (11/81) or died intraoperatively (8/81) belonged to the TAPSE <18 mm group. Logistic regression analysis confirmed TAPSE <18 mm as an independent risk factor for intraoperative cardiopulmonary resuscitation and death. CONCLUSIONS: Transesophageal echocardiography derived TAPSE is easily obtainable and correlates well with other standardized parameters of right ventricular function. TAPSE <18 mm is an independent predictor of intraoperative cardiopulmonary resuscitation and death in patients undergoing emergent pulmonary embolectomy. EDIMES Edizioni Internazionali Srl 2015 /pmc/articles/PMC4476769/ /pubmed/26157741 Text en Copyright © 2015, Heart, Lung and Vessels http://creativecommons.org/licenses/by-nc/3.0/ This article is distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research-Article
Schmid, Eckhard
Hilberath, Jan N
Blumenstock, Gunnar
Shekar, Prem S
Kling, Steffen
Shernan, Stanton K
Rosenberger, Peter
Nowak-Machen, Martina
Tricuspid annular plane systolic excursion (TAPSE) predicts poor outcome in patients undergoing acute pulmonary embolectomy
title Tricuspid annular plane systolic excursion (TAPSE) predicts poor outcome in patients undergoing acute pulmonary embolectomy
title_full Tricuspid annular plane systolic excursion (TAPSE) predicts poor outcome in patients undergoing acute pulmonary embolectomy
title_fullStr Tricuspid annular plane systolic excursion (TAPSE) predicts poor outcome in patients undergoing acute pulmonary embolectomy
title_full_unstemmed Tricuspid annular plane systolic excursion (TAPSE) predicts poor outcome in patients undergoing acute pulmonary embolectomy
title_short Tricuspid annular plane systolic excursion (TAPSE) predicts poor outcome in patients undergoing acute pulmonary embolectomy
title_sort tricuspid annular plane systolic excursion (tapse) predicts poor outcome in patients undergoing acute pulmonary embolectomy
topic Research-Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4476769/
https://www.ncbi.nlm.nih.gov/pubmed/26157741
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