cardiotomskСибирский журнал клинической и экспериментальной медициныSiberian Journal of Clinical and Experimental Medicine2713-29272713-265XTSU publishing10.29001/2073-8552-2025-40-1-69-76cardiotomsk-2634Research ArticleКЛИНИЧЕСКИЕ ИССЛЕДОВАНИЯCLINICAL STUDIESАмплитуда систолического смещения плоскости фиброзного кольца трикуспидального клапана в оценке сократимости правого желудочка у детейThe use of tricuspid annular plane systolic excursion in assessment of right ventricular contractility in childrenhttps://orcid.org/0000-0002-6531-7223СморгонА. В.SmorgonA. V.

Сморгон Андрей Владимирович, младший научный сотрудник, лаборатория ультразвуковых и функциональных методов исследований

634012, Томск, ул. Киевская, 111а

Andrey V. Smorgon, Junior Research Scientist, Laboratory of Ultrasound and Functional Research Methods

111a, Kievskaya str., Tomsk, 634012

sav@cardio-tomsk.ruhttps://orcid.org/0000-0003-0513-9012СоколовА. А.SokolovA. A.

Соколов Александр Анатольевич, д-р мед. наук, профессор, заведующий лабораторией ультразвуковых и функциональных методов исследования

634012, Томск, ул. Киевская, 111а

Alexander A. Sokolov, Dr. Sci. (Med.), Professor, Head of the Department of Functional and Laboratory Diagnostics

111a, Kievskaya str., Tomsk, 634012

asa@cardio-tomsk.ruhttps://orcid.org/0000-0002-9886-0695СолдатенкоМ. В.SoldatenkoM. V.

Солдатенко Михаил Владимирович, канд. мед. наук, научный сотрудник, лаборатория ультразвуковых и функциональных методов исследований

634012, Томск, ул. Киевская, 111а

Michail V. Soldatenko, Cand. Sci. (Med.), Research Sientist, Laboratory of Ultrasound and Functional Research Methods

111a, Kievskaya str., Tomsk, 634012

able99@mail.ruНаучно-исследовательский институт кардиологии, Томский национальный исследовательский медицинский центр Российской академии наук (НИИ кардиологии Томского НИМЦ)РоссияCardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences (Cardiology Research Institute, Tomsk NRMC)Russian Federation2025120420254016976Copyright © Сморгон А.В., Соколов А.А., Солдатенко М.В., 20252025Сморгон А.В., Соколов А.А., Солдатенко М.В.Smorgon A.V., Sokolov A.A., Soldatenko M.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.sibjcem.ru/jour/article/view/2634

Эхокардиографическая оценка сократимости правого желудочка (ПЖ) является сложной задачей из-за его особой формы. Чаще всего для определения сократимости ПЖ используются два показателя: амплитуда систолического смещения плоскости фиброзного кольца трикуспидального клапана (tricuspid annular plane systolic excursion, TAPSE) и изменение площади фракции (fractional area change, FAC) ПЖ. Корректность использования TAPSE в последнее время все чаще подвергается сомнению.

Цель исследования

Цель исследования: изучить связь TAPSE с сократимостью ПЖ, изменением объемов правых камер у детей с дефектом межпредсердной перегородки (ДМПП) в процессе хирургического лечения, а также оценить взаимосвязь TAPSE с показателями антропометрии.

Материал и методы

Материал и методы. Исследование выполнено на основании ретроспективного анализа двумерных (2D) эхокардиографических данных. Референтным методом для оценки сократимости ПЖ была трехмерная эхокардиография (3D-эхо).

Результаты

Результаты. По результатам ретроспективного корреляционного анализа данных эхокардиографии у 729 здоровых детей в возрасте 1–17 лет и 120 детей с ДМПП того же возраста установлена максимальная взаимосвязь TAPSE с возрастом (r = 0,54) и антропометрическими данными (r = 0,59). Отмечена достаточно высокая корреляция между линейными размерами правого предсердия (ПП) и ПЖ (r = 0,59). Корреляция TAPSE и фракции выброса (ФВ) ПЖ, по данным 3D-эхо, отсутствовала в контрольной группе и у детей с ДМПП. Показатель был оценен в ближайшем будущем (6 дней) и в отдаленный период (1–3 года) после хирургической коррекции у 60 детей с ДМПП и у 30 детей с коарктацией аорты (КоА). На всех этапах после операции значение TAPSE снижалось у всех прооперированных пациентов, не восстанавливалось через 1 год и не имело корреляционной связи с ФВ ПЖ, согласно данным 3D-эхо.

Выводы

Выводы. У детей без структурной патологии сердца показатель TAPSE не отражает сократимость ПЖ и зависит от антропометрических данных, линейных размеров правых камер. У детей с ДМПП TAPSE в большей мере характеризует объемную перегрузку правых камер, чем сократимость ПЖ. Сократимость ПЖ у детей после кардиохирургических операций не может быть корректно оценена с использованием TAPSE.

Echocardiographic assessment of the contractility of the right ventricle (RV) is a difficult task due to its special shape. Two indicators are most often used to assess pancreatic contractility: the amplitude of the systolic displacement of the plane of the fibrous ring of the tricuspid valve and right ventricular fractional area change (FAC) due to good reproducibility and ease of measurement. The correctness of using TAPSE has been increasingly questioned lately.

Aim

Aim: To study the association of tricuspid annular plane systolic excursion (TAPSE) with pancreatic contractility, changes in the volume of the right chambers in children with atrial septal defect (ASD) during surgical treatment. To evaluate the relationship of TAPSE with the indicators of anthropometry.

Material and Methods

Material and Methods. The examination was performed on the basis of a retrospective analysis of two-dimensional echocardiographic data. Three-dimensional echocardiography (3D echo) was the reference method for assessing RV contractility.

Results

Results. Based on a retrospective correlation analysis of echocardiography data in 729 healthy children aged 1–17 years and 120 children with ASD of the same age, it was found that the maximum relationship between TAPSE was observed with age (r = 0.54) and anthropometric data (r = 0.59). There was a fairly high correlation between the linear dimensions of the right atrium and the right ventricle (r = 0.59). The correlation of TAPSE and RV ejection fraction (EF) according to 3D echo data was absent in the control group and in children with ASD. The indicator was evaluated in the near future (6 days) and in the long term (1–3 years) after surgical correction in 60 children with ASD and 30 with coarctation of the aorta. At all stages after surgery, the indicator decreased in all operated patients, did not recover after 1 year and had no correlation with the pancreatic ejection fraction according to 3D echo data.

Conclusions

Conclusions. In children without structural pathology of the heart, the TAPSE indicator does not reflect the contractility of the right ventricle and depends on anthropometric data and the linear dimensions of the right chambers. TAPSE in ASD children was more depended by volumetric overload of the right chambers than by contractility of the right ventricle. Contractility of the right ventricle in children after cardiac surgery cannot be correctly assessed using TAPSE.

TAPSEдефекты межпредсердной перегородкикоарктация аортыправый желудочек3D-эхокардиографиядетиtricuspid annular plane systolic excursionTAPSEatrial septal defectscoarctation of the aorta3D transthoracic echocardiographyright ventricleReferencesRudski L.G., Lai W.W., Afilalo J., Hua L., Handschumacher M.D., Chandrasekaran K. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J. Am. Soc. Echocardiogr. 2010;23(7):685–713; quiz 786–788. https://doi.org/10.1016/j.echo.2010.05.010Rudski L.G., Lai W.W., Afilalo J., Hua L., Handschumacher M.D., Chandrasekaran K. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J. Am. Soc. Echocardiogr. 2010;23(7):685–713; quiz 786–788. https://doi.org/10.1016/j.echo.2010.05.010James A.T., Corcoran J.D., Franklin O., El-Khuffash A.F. Clinical utility of right ventricular fractional area change in preterm infants. Early Hum. Dev. 2016:92:19–23. https://doi.org/10.1016/j.earlhumdev.2015.10.015James A.T., Corcoran J.D., Franklin O., El-Khuffash A.F. Clinical utility of right ventricular fractional area change in preterm infants. Early Hum. Dev. 2016:92:19–23. https://doi.org/10.1016/j.earlhumdev.2015.10.015Focardi M., Cameli M., Carbone S.F., Massoni A., De Vito R., Lisi M., Mondillo S. Traditional and innovative echocardiographic parameters for the analysis of right ventricular performance in comparison with cardiac magnetic resonance. Eur. Heart J. Cardiovasc. Imaging. 2015;16(1):47– 52. https://doi.org/10.1093/ehjci/jeu156Focardi M., Cameli M., Carbone S.F., Massoni A., De Vito R., Lisi M., Mondillo S. Traditional and innovative echocardiographic parameters for the analysis of right ventricular performance in comparison with cardiac magnetic resonance. Eur. Heart J. Cardiovasc. Imaging. 2015;16(1):47– 52. https://doi.org/10.1093/ehjci/jeu156Koestenberger M., Nagel B., Avian A., Ravekes W., Sorantin E., Cvirn G. et al. Systolic right ventricular function in children and young adults with pulmonary artery hypertension secondary to congenital heart disease and tetralogy of Fallot: tricuspid annular plane systolic excursion (TAPSE) and magnetic resonance imaging data. Congenit. Heart Dis. 2012;7(3):250–258. https://doi.org/10.1111/j.1747-0803.2012.00655.xKoestenberger M., Nagel B., Avian A., Ravekes W., Sorantin E., Cvirn G. et al. Systolic right ventricular function in children and young adults with pulmonary artery hypertension secondary to congenital heart disease and tetralogy of Fallot: tricuspid annular plane systolic excursion (TAPSE) and magnetic resonance imaging data. Congenit. Heart Dis. 2012;7(3):250–258. https://doi.org/10.1111/j.1747-0803.2012.00655.xKanzaki H., Nakatani S., Kawada T., Yamagishi M., Sunagawa K., Miyatake K. Right ventricular dP/dt/P(max), not dP/dt(max), noninvasively derived from tricuspid regurgitation velocity is a useful index of right ventricular contractility. J. Am. Soc. Echocardiogr. 2002;15(2):136–142. https://doi.org/10.1067/mje.2002.115773Kanzaki H., Nakatani S., Kawada T., Yamagishi M., Sunagawa K., Miyatake K. Right ventricular dP/dt/P(max), not dP/dt(max), noninvasively derived from tricuspid regurgitation velocity is a useful index of right ventricular contractility. J. Am. Soc. Echocardiogr. 2002;15(2):136–142. https://doi.org/10.1067/mje.2002.115773Соколов А.А., Марцинкевич Г.И. Трехмерные, двухмерные и неволюметрические эхокардиографические методы оценки контрактильности правого желудочка. Кардиология в Беларуси. 2016;8(1):98–107.Sokolov A.A., Martsinkevich G.I. The evaluation of contractility of the right ventricle by three and two-dimensional echocardiographia and with using non volumetric methods. Kardiologiya v Belarusi. 2016;8(1):98– 107.Martha J.W., Pranata R., Wibowo A., Lim M.A. Tricuspid annular plane systolic excursion (TAPSE) measured by echocardiography and mortality in COVID-19: A systematic review and meta-analysis. Int. J. Infect. Dis. 2021;105:351–356. https://doi.org/10.1016/j.ijid.2021.02.029Martha J.W., Pranata R., Wibowo A., Lim M.A. Tricuspid annular plane systolic excursion (TAPSE) measured by echocardiography and mortality in COVID-19: A systematic review and meta-analysis. Int. J. Infect. Dis. 2021;105:351–356. https://doi.org/10.1016/j.ijid.2021.02.029Mądry W., Karolczak M.A., Myszkowski M. Critical appraisal of MAPSE and TAPSE usefulness in the postoperative assessment of ventricular contractile function after congenital heart defect surgery in infants. J. Ultrason. 2019;19(76):9–16. https://doi.org/10.15557/JoU.2019.0002Mądry W., Karolczak M.A., Myszkowski M. Critical appraisal of MAPSE and TAPSE usefulness in the postoperative assessment of ventricular contractile function after congenital heart defect surgery in infants. J. Ultrason. 2019;19(76):9–16. https://doi.org/10.15557/JoU.2019.0002Sokolov A.A., Varvarenko V.I., Egunov O.A., Smorgon A.V. Left atrial shape and function after endovascular and surgery atrial septal defects correction in children. Siberian Journal of Clinical and Experimental Medicine. 2024;39(4):162–170. https://doi.org/10.29001/2073-8552-2024-39-4-162-170Sokolov A.A., Varvarenko V.I., Egunov O.A., Smorgon A.V. Left atrial shape and function after endovascular and surgery atrial septal defects correction in children. Siberian Journal of Clinical and Experimental Medicine. 2024;39(4):162–170. https://doi.org/10.29001/2073-8552-2024-39-4-162-170Valle С., Ujvari A., Elia E., Lu M., Gauthier N., Hoganson D. et al. Right ventricular contraction patterns in healthy children using three-dimensional echocardiography. Front. Cardiovasc. Med. 2023:10:1141027. https://doi.org/10.3389/fcvm.2023.1141027Valle С., Ujvari A., Elia E., Lu M., Gauthier N., Hoganson D. et al. Right ventricular contraction patterns in healthy children using three-dimensional echocardiography. Front. Cardiovasc. Med. 2023:10:1141027. https://doi.org/10.3389/fcvm.2023.1141027Meyer P., Filippatos G.S., Ahmed M.I., Iskandrian A.E., Bittner V., Perry G.J. et al. Effects of right ventricular ejection fraction on outcomes in chronic systolic heart failure. Circulation. 2010;121(2):252–258. https://doi.org/10.1161/circulationaha.109.887570Meyer P., Filippatos G.S., Ahmed M.I., Iskandrian A.E., Bittner V., Perry G.J. et al. Effects of right ventricular ejection fraction on outcomes in chronic systolic heart failure. Circulation. 2010;121(2):252–258. https://doi.org/10.1161/circulationaha.109.887570Melenovsky V., Kotrc M., Borlaug B.A., Marek T., Kovar J., Malek I. et al. Relationships between right ventricular function, body composition, and prognosis in advanced heart failure. J. Am. Coll. Cardiol. 2013;62(18):1660–1670. https://doi.org/10.1016/j.jacc.2013.06.046Melenovsky V., Kotrc M., Borlaug B.A., Marek T., Kovar J., Malek I. et al. Relationships between right ventricular function, body composition, and prognosis in advanced heart failure. J. Am. Coll. Cardiol. 2013;62(18):1660–1670. https://doi.org/10.1016/j.jacc.2013.06.046Ghio S., Recusani F., Klersy C., Sebastiani R., Laudisa M., Campana C. et al. Prognostic usefulness of the tricuspid annular plane systolic excursion in patients with congestive heart failure secondary to idiopathic or ischemic dilated cardiomyopathy. Am. J. Cardiol. 2000;85(7):837–842. https://doi.org/10.1016/s0002-9149(99)00877-2Ghio S., Recusani F., Klersy C., Sebastiani R., Laudisa M., Campana C. et al. Prognostic usefulness of the tricuspid annular plane systolic excursion in patients with congestive heart failure secondary to idiopathic or ischemic dilated cardiomyopathy. Am. J. Cardiol. 2000;85(7):837–842. https://doi.org/10.1016/s0002-9149(99)00877-2Mercer-Rosa L., Parnell A., Forfia P.R., Yang W., Goldmuntz E., Kawut S.M. Tricuspid annular plane systolic excursion in the assessment of right ventricular function in children and adolescents after repair of tetralogy of Fallot. J. Am. Soc. Echocardiogr. 2013;26(11):1322–1329. https://doi.org/10.1016/j.echo.2013.06.022Mercer-Rosa L., Parnell A., Forfia P.R., Yang W., Goldmuntz E., Kawut S.M. Tricuspid annular plane systolic excursion in the assessment of right ventricular function in children and adolescents after repair of tetralogy of Fallot. J. Am. Soc. Echocardiogr. 2013;26(11):1322–1329. https://doi.org/10.1016/j.echo.2013.06.022Núñez-Gil I.J., Rubio M.D., Cartón A.J., López-Romero P., Deiros L., García-Guereta L. et al. Determination of normalized values of the tricuspid annular plane systolic excursion (TAPSE) in 405 Spanish children and adolescents. Rev. Esp. Cardiol. 2011;64(8):674–680. https://doi.org/10.1016/j.recesp.2011.04.006Núñez-Gil I.J., Rubio M.D., Cartón A.J., López-Romero P., Deiros L., García-Guereta L. et al. Determination of normalized values of the tricuspid annular plane systolic excursion (TAPSE) in 405 Spanish children and adolescents. Rev. Esp. Cardiol. 2011;64(8):674–680. https://doi.org/10.1016/j.recesp.2011.04.006Akula V.S., Durgaprasad R., Velam V., Kasala L., Rodda M., Erathi H.V. Right ventricle before and after atrial septal defect device closure. Echocardiography. 2016;33(9):1381–1388. https://doi.org/10.1111/echo.13250Akula V.S., Durgaprasad R., Velam V., Kasala L., Rodda M., Erathi H.V. Right ventricle before and after atrial septal defect device closure. Echocardiography. 2016;33(9):1381–1388. https://doi.org/10.1111/echo.13250Ağaç M.T., Akyüz A.R., Acar Z., Akdemir R., Korkmaz L., Kırış A. et al. Evaluation of right ventricular function in early period following transcatheter closure of atrial septal defect. Echocardiography. 2012;29(3):358–362. https://doi.org/10.1111/j.1540-8175.2011.01558.xAğaç M.T., Akyüz A.R., Acar Z., Akdemir R., Korkmaz L., Kırış A. et al. Evaluation of right ventricular function in early period following transcatheter closure of atrial septal defect. Echocardiography. 2012;29(3):358–362. https://doi.org/10.1111/j.1540-8175.2011.01558.xLi H., Ye T., Su L., Wang J., Jia Z., Wu Q. et al. Assessment of right ventricular-arterial coupling by echocardiography in patients with right ventricular pressure and volume overload. Rev. Cardiovasc. Med. 2023;24(12):366. https://doi.org/10.31083/j.rcm2412366Li H., Ye T., Su L., Wang J., Jia Z., Wu Q. et al. Assessment of right ventricular-arterial coupling by echocardiography in patients with right ventricular pressure and volume overload. Rev. Cardiovasc. Med. 2023;24(12):366. https://doi.org/10.31083/j.rcm2412366Bitcon C.J., Tousignant C. The effect of pericardial incision on right ventricular systolic function: a prospective observational study. Can. J. Anaesth. 2017;64(12):1194–1201. https://doi.org/10.1007/s12630-017-0972-3Bitcon C.J., Tousignant C. The effect of pericardial incision on right ventricular systolic function: a prospective observational study. Can. J. Anaesth. 2017;64(12):1194–1201. https://doi.org/10.1007/s12630-017-0972-3Raina A., Vaidya A., Gertz Z.M., Chambers S., Forfia P.R. Marked changes in right ventricular contractile pattern after cardiothoracic surgery: implications for post-surgical assessment of right ventricular function. J. Heart Lung. Transplant. 2013;32(8):777–783. https://doi.org/10.1016/j.healun.2013.05.004Raina A., Vaidya A., Gertz Z.M., Chambers S., Forfia P.R. Marked changes in right ventricular contractile pattern after cardiothoracic surgery: implications for post-surgical assessment of right ventricular function. J. Heart Lung. Transplant. 2013;32(8):777–783. https://doi.org/10.1016/j.healun.2013.05.004

The authors declare that there are no conflicts of interest present.