130 Interest of tricuspid annular displacement “TAD” in evaluation of right ventricular ejection fraction

The ultrasound assessment of right ventricular (RV) function is often sub-optimal. The range of excursions of the mitral or tricuspid annulus measured in mm by 2D or TM mode echocardiography has been shown to reflect the systolic function of both ventricles.MethodsWe studied a new technique based on a tissue tracking algorithm that is ultrasound beam angle independent for automated detection of tricuspid annular displacement (TAD) (QLAB, Philips Medical Imaging). Twenty six patients (pts) with pulmonary arterial hypertension (n= 13), heart failure (n= 9), valvulopathy (n= 3) or myocarditis (n= 1) were reffered for magnetic resonance imaging (MRI) and underwent a complete transthoracic echocardiography (TTE). MRI was performed on a 1.5 T MR scanner. MRI RV ejection fraction (RVEF) was correlated by linear regression with TAD, peak systolic tricuspid annular velocity (Sa) and RV fractional area change (FAC). Sixteen pts (61.5%) exhibited right ventricular systolic dysfunction (RVEF < 40%). TTE was performed in 44 healthy subjects in order to assess normal TAD value.ResultsIn the pts group, MRI RVEF was positively correlated with TAD (R2= 0,65; p< 0,0001), Sa (R2= 0,56; p< 0,0001) and FAC (R2= 0,39 p=0,0025). The strongest relation was observed with TAD. A value of TAD< 14 mm predicted right ventricular dysfunction with a sensitivity of 87.5% and a specificity of 90%. Most of (90%) healthy subjects exhibited TAD values exceeding this cut-off point (mean 16,9 +/- 1,64 mm, range 13,3 to 24,8 mm). Negative correlation was found between TAD and age (R2=0,36 ; p