Improvement in Tricuspid Annular Plane Systolic Excursion with Pulmonary Hypertension Therapy in Pediatric Patients.

Background Tricuspid annular plane systolic excursion ( TAPSE) has emerged as a novel and reliable measure of right ventricular ( RV) function. The purpose of this study was to determine the effect of pulmonary hypertension ( PH) therapy on TAPSE in pediatric patients and compare TAPSE to other quantitative measures of RV function. Methods A retrospective review of medical records and echocardiograms of patients in the PH clinic from January 2011 to August 2013 was done. Echocardiograms were analyzed prior to initiation or addition of a PH drug and at least 8 weeks later. Following quantitative measures of RV function were compared: TAPSE, TAPSE age-based z-score, RV fractional area change ( RVFAC), tricuspid annular S′, tricuspid inflow E/tricuspid annular E′ velocity ( TV E/E′), and RV myocardial performance index ( RVMPI). Results Of the 37 patients included in this study (median age 0.6 years), 23 (62.2%) were treatment naive and others had a new PH drug added to their regimen at the time of the baseline echocardiogram. The median duration between the baseline and follow-up echocardiogram was 8 (2-25) months. There was a significant improvement in TAPSE and TAPSE age-based z-score on the follow-up echocardiogram. RVFAC, tricuspid S′, TV E/E′, and RVMPI did not show a statistically significant change. Conclusion In contrast to the other echocardiographic markers of RV function, TAPSE, and TAPSE age-based z-score significantly improve after initiation or addition of PH therapy and can be used for serial noninvasive monitoring of RV function in pediatric PH patients. [ABSTRACT FROM AUTHOR]