Tissue tricuspid annular displacement (TTAD) is a new echocardiographic tool for functional assessment of right ventricle (RV) based on speckle tracking. It allows measurement of the displacement of the tricuspid annulus relative to the apex of RV in the standard apical four chamber (4CH) view.
The aim of this study is investigation if TTAD analysis might be used interchangeably with commonly used echocardiographic RV functional markers.
In this retrospective study we included 65 patients (44 men, mean age 63,89±14,68 years), who underwent 2D transthoracic echocardiographic examination. Two patients were excluded due to insufficient visualization of RV. Tricuspid annular plane systolic excursion (TAPSE) was measured. Afterward, off-line measurements of RV fractional area change (RV FAC), as well as line measurements of TTAD were obtained in 62 patients; 1 person was excluded due to artifacts affecting the proper analysis.
The feasibility of TTAD is 95,4%. Mean values of RV FAC, the midpoint tricuspid annulus displacement towards the RV apex (TTAD mpt) and the percentage of the midpoint tricuspid annulus displacement (TTAD%) were 40,2±12,9%, 10,3±4,6 mm and 15±6,7%, respectively. The distribution of TAPSE values was not normal, therefore Spearman’s rank correlation was performed for TAPSE vs TTAD mpt (rho=0,603, p<0,0001) & TAPSE vs TTAD% (rho=0,637, p<0,0001). Due to normal distribution of RV FAC, correlation coefficient was checked for RV FAC vs TTAD mpt (r=0,4448, p=0,0003) & RV FAC vs TTAD% (r=0,519, p<0,0001). TAPSE also correlated with RV FAC (rho=0,459, p=0,0002). AUC for TTAD mpt and TTAD% for detecting RV dysfunction defined as TAPSE <17 mm were 0,828 (p=0,0001) and 0,834 (p=0,0001) respectively. The threshold value of TTAD mpt of =11,5 mm had 100% sensitivity and 52,1% specificity, whereas the threshold for TTAD% of =11,9% had 78,6% sensitivity and 72,9% specificity.
TTAD analysis results correlate significantly with well-established RV function parameters such as TAPSE & RV FAC and it is applicable in a similar number of patients.