Simple Monitoring of RV-...
Highlights
- Simple monitoring of RV-PA coupling using TAPSE
Take home:
1⃣Systolic function 🟰 Ventriculoarterial coupling
2⃣We can increase the precision of TAPSE by leveraging the ease of measuring several beats.
#FOAMcc #ThePeoplesVentricle #CardioTwitter #EchoFirst #FOAMed #POCUS
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- This study compared echo with invasive right ventricular PV-loops. TAPSE has good correlation RV-PA coupling; better than TAPSE/PASP-ratio! The value of TAPSE/PASP seems to be in its correlation to myocardial oxygen consumption.
Ref: https://t.co/zJWLZngzpW
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- RV FAC had even better correlation with RV-PA coupling, with r = 0.9! This demonstrates that parameters of systolic function actually represent ventriculoarterial coupling, which makes perfect physiological sense.
Ref: https://t.co/zJWLZngzpW
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- Interestingly, the cut-offs for TAPSE, FAC and RVEF (from CMRI) for predicting RV-PA uncoupling is close to the cut offs in guidelines, with impressive test characteristics!
Ref: https://t.co/uY96h335lY
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- Challenge with FAC:⬆️observer variability due to variability in image acquisition and in tracing. High variability means that larger changes in FAC is needed for us to interpret it as a change in patient condition and not just random variation.
Ref: https://t.co/pLsnq6t6Ne
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- TAPSE has less observer variability. Also, TAPSE has 2⃣strong advantages when it comes to hemodynamic monitoring...
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- ...1⃣TAPSE is fast and easy to measure, which means that we actually measures it. 2⃣It is much easier to measure multiple TAPSE. This must be leveraged as much as possible! Because...
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- By measuring more beats and averaging them, the estimate of RV-PA coupling is more precise. This means that, if we always average TAPSE over several beats, much smaller changes can be ascribes to a true change.
Ref: https://t.co/3hLmD44sg2
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- I think we should leverage this phenomena in all measurements where multiple measurements are easy. TAPSE has been used as example, but, MAPSE, RV s', LV s' are also up for grabs. Also, this is where automatic measurements are powerful #AutoMAPSE
9/n https://t.co/GM8HGtBj2b (View Tweet)
- In conclusion:
1⃣ #EchoFirst parameters of RV function correlates very well with RV-PA coupling by conductance catheter🎇
2⃣TAPSE is powerful for hemodynamic monitoring because it is easy to measure multiple beats, which⬆️precision and the ability to detect change.
10/10
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