Tricuspid annular plane systolic excursion (TAPSE) reflects longitudinal myocardial shortening the main component of right ventricular (RV) contraction in normal hearts. tricuspid valve annulus was measured on CMR (using four-chamber cine images) and on TTE (using two-dimensional apical views). To create TTE-TAPSE score ?8.7 ± 1.0). The mean difference in TAPSE between CMR and TTE was ?0.13 cm [95 % confidence interval (CI) ?0.21 to ?0.05] with 95 %limits of agreement (?0.55 to 0.29 cm). The study showed no association between CMR-TAPSE and RVEF (= 0.08; = 0.67). In individuals with HLHS after Fontan TAPSE is definitely reproducible on CMR and TTE with good agreement between the two imaging methods. Diminished TAPSE suggests impaired longitudinal shortening in the Calcitetrol systemic RV. However TAPSE is not a surrogate for RVEF with this study human population. tests. The associations between TAPSE and CMR-derived actions of RV function or additional pertinent covariates were identified with Pearson’s correlation coefficients. Multivariable linear regression was used to assess the association of TAPSE (impartial variable) Calcitetrol with CMR TTE and clinical parameters of interest (dependent variables). The reliability of TTE- and CMR-TAPSE was assessed using intraclass correlation coefficient estimates. Intertechnique agreement of TTE and CMR was assessed with Bland-Altman analysis. All data analyses were performed using Stata version 11.2 (StataCorp LP College Station TX USA). Statistical significance was defined as a value lower than 0.05. Results During this study 29 patients (67 % male 87 % Caucasian) met the inclusion criteria and underwent 30 CMRs. The age at CMR was 14.1 ± 7.1 Calcitetrol years performed 11.9 ± 7.8 years after Fontan. Other patient characteristics are explained in Table 1. The CMRs and TTEs were performed 2.3 ± 1.7 months apart. Table 1 Demographic characteristics of the study population Separate from your 29 included patients 10 additional HLHS patients with Fontan blood circulation underwent CMR and TTE during the study period. These 10 patients were excluded from the study due to insufficient CMR images (= 8) or a history of tricuspid valve intervention (= 2). The included and excluded patients did not differ in terms of race anatomic subtype distribution of sex Fontan type fenestration status or age at Fontan. The excluded patients were more youthful (6.9 ± 3.2 years) than the included patients (= 0.004) with fewer years since Fontan (4.3 ± 4.1 years; = 0.005). However 6 of the 10 excluded patients underwent CMR as part of a research protocol that did not include the full short-axis volume set necessary for calculation of RVEF. The study recruited younger patients earlier in the course of staged palliation. The intraclass correlation coefficients (ICC) for interand intraobserver variability were respectively 0.89 (95 % CI 0.74-1.00) and 0.91 (95 % CI 0.84-0.97) for CMR-TAPSE and 0.94 (95 % CI 0.88-1.00) and 0.99 (95 % CI 0.98-1.00) for TTE-TAPSE (Table 2). The CMR-TAPSE measurement was slightly lower than the TTE-TAPSE measurement (0.57 ± 0.2 vs. 0.70 ± 0.2 Rabbit Polyclonal to AKAP1. cm respectively) (Table 3). The two measurements were moderately correlated (= 0.46; = 0.01). The mean difference in TAPSE between CMR and TTE was ?0.13 cm (95 % CI ?0.21 to ?0.05) with 95 % limits of agreement of ?0.5 to 0.28 (Fig. 1). Fig. 1 The imply difference in tricuspid annular plane systolic excursion (TAPSE) between cardiac magnetic resonance (CMR) and transthoracic echocardiogram (TTE) was ?0.13 Calcitetrol cm with 95 % limits of agreement of ?0.55 to +0.29 (SD ± 0.04 … Table 2 Inter- and intraobserver variability for CMR- and TTE-TAPSE Table 3 CMR and TTE variables On TTE the TAPSE score ?8.7 ± 1.0; range ?10 to ?5.7). On CMR RV function was preserved overall with an RVEF of 55 % ± 13 %. However 27 % of the patients (= 8) experienced an RVEF lower than 50 %. Tricuspid regurgitation was assessed in 15 subjects (50 %) 4 of whom experienced more than moderate regurgitation (regurgitant portion >20 %) (Table 2). One individual experienced a tricuspid regurgitant portion of 97 % and severely diminished RV function (RVEF 27 %) in the setting of tricuspid valve dysplasia. Tricuspid regurgitation was not associated with RVEF in the group.