Value of Semiquantitative Assessment of Right Ventricular Systolic Function with A Modified Subcostal Echocardiographic View

Abstract

Background: the assessment of right ventricular function (RVF) is an important component of routine echocardiography study. Tricuspid annular plane systolic excursion (TAPSE) is easy and validated method of RVF but in many patients, this method may be difficult to apply due to inadequate apical window. So, we proposed that Subcostal Echocardiographic assessment of Tricuspid annular Kick (SEATAK) could be comparable to TAPSE. Aims of the study: they were to assess of RVF with a new arising method SEATAK, to determine the sensitivity & specificity of SEATAK and correlation between SEATAK & TAPSE with the degree of RVF. Patients and Methods: this study included 100 consecutive patients presented to our echocardiography lab with different clinical indications. Right ventricular function was assessed by the following parameters: RV Myocardial Performance Index (RIMP), TAPSE, Peak Systolic velocity of right ventricular basal free wall by TDI (TASVTDI), SEATAK and Fractional Area Change (FAC) as reference method for RVF assessment. Results: according to RVF using FAC, the patient were classified into 2groups,group with FAC ≥35% and other with FAC <35%. There was a significant statistical difference between both study groups according to TAPSE (cm), SEATAK (cm), P-Value ˂0.05. SEATAK was significantly correlated with TAPSE, TASV-TDI, and FAC values. SEATAK cutoff value ≥1.60 cm has the highest combined sensitivity and specificity of 86% &67% respectively for normal RVF (FAC ≥35%). Positive& negative predictive values are 72% &83%, respectively. Area under the curve equals 0.79, P-Value < 0.001. Conclusion: SEATAK is correlated with TAPSE, TASV-TDI & FAC for evaluation of RVF with cut-off value of SEATAK for prediction of normal RVF is ≥1.60 with sensitivity and specificity of 86% &67% respectively