Estimation of Right Ventricular Dysfunction by the Ratio of Tricuspid Annular Plane Systolic Excursion to Pulmonary Artery Systolic Pressure in Chronic Obstructive Pulmonary Disease Patients: A cross-sectional study

Authors

  • Sanjaya Kumar Shrestha Asscociate Professor, Department of Medicine (Cardiology), Kathmandu Medical College, Sinamangal, Kathmandu, Nepal.
  • Anmol Prasad Shrestha Department of Community Medicine, Kathmandu Medical College and Teaching Hospital, Kathmandu, Nepal
  • Tunam Khadka Department of Cardiology, Kathmandu Medical College and Teaching Hospital, Kathmandu, Nepal

Keywords:

COPD, Echocardiography, Pulmonary Artery Systolic Pressure, Right ventricle dysfunction, Tricuspid Annular Plane Systolic Excursion

Abstract

Introduction: A significant morbidity and mortality in chronic obstructive pulmonary disease (COPD) patients is due to right ventricular (RV) dysfunction and failure. We aimed to assess the severity of RV dysfunction with the relatively new but well validated echocardiographic index of tricuspid annular plane systolic excursion (TAPSE) to pulmonary artery systolic pressure (PASP) that measures the extent of shortening of cardiac fibers during RV contraction against a given afterload, the index of cardiac length-force relationship.

Methodology: This cross-sectional study was conducted on COPD patients admitted to Kathmandu Medical College hospital, between October to November 2022 after approval from the Institutional Review Committee (Reference: KMC/18102022/07). The convenience sampling method was used and clinico-demographic details of the patients were recorded. Echocardiographic evaluation of the RV function was done by measuring the TAPSE/PASP ratio, as the non-invasive index of RV to pulmonary artery coupling.

Results: The median ± interquartile range of TAPSE, PASP, TAPSE/PASP ratio, and RV diameter of the patients were 19±6 mm, 47±19 mmHg, 0.39±0.19 mm/ mmHg, and 3.8±0.7 cm respectively. 23% of the patients had a TAPSE/PASP ratio of ?0.3mm/mmHg, denoting severe RV dysfunction. TAPSE/PASP ratio had a significant negative correlation with RV diameter (rho = -0.26; p=0.018); modified Medical 2 Research Council dyspnea grade at admission (rho = -0.35; p = 0.001); and domiciliary oxygen use (? = -0.26; p = 0.017).

Conclusion: The TAPSE/PASP ratio is a meaningful diagnostic parameter for the severity of COPD patients with pulmonary hypertension, and could be a good prognostic indicator.

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Published

2023-05-19

How to Cite

1.
Kumar Shrestha S, Prasad Shrestha A, Khadka T. Estimation of Right Ventricular Dysfunction by the Ratio of Tricuspid Annular Plane Systolic Excursion to Pulmonary Artery Systolic Pressure in Chronic Obstructive Pulmonary Disease Patients: A cross-sectional study. J. KIST Med. Col [Internet]. 2023 May 19 [cited 2024 Dec. 4];5(9):11-6. Available from: https://jkistmc.org.np/jkistmc/index.php/JKISTMC/article/view/250

Issue

Vol. 5 No. 9 (2023): Journal of KIST Medical College

Section

Original Article

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