Echocardiographic Assessment of Right Ventricular Systolic Function: A 2D, Anatomical, and Conventional M-Mode Comparison Study

Objectives: We aimed to compare tricuspid annular plane systolic excursion (TAPSE) by anatomical M-mode (AMM) and conventional M-mode (CMM) with right ventricular fractional area change (RV-FAC) for the evaluation of RV systolic function. Methods: Between February 2013 and February 2014, 152 patients, who were admitted to our echocardiography department for the evaluation of cardiac function, were prospectively enrolled in the study. All the patients underwent CMM and 2D echocardiography and AMM echocardiography. Results: The mean age of the patients was 53.27 ± 14.29 years and 52.9% were male. The patients were mostly diagnosed as having left-sided valvular disease in terms of mitral stenosis, mitral regurgitation, aortic stenosis, or aortic regurgitation (63 patients, 41.4%). Heart failure was in 18.4% and coronary artery disease in 15.8%. Among 152 patients, 17 (11.2%) had normal findings in echocardiography. Concerning RV-FAC, we categorized the patients into 3 groups: 116 patients with RV-FAC equal to or greater than 35%, 24 patients with RV-FAC between 35% and 25%, and 12 patients with RV-FAC equal to or smaller than 25%. To discriminate normal from abnormal RV-FACs (≥ 35% vs < 35%), TAPSE by AMM had specificity of 96.5% and sensitivity of 60.5% (P < 0.001) for a cutoff point of 19.5 mm to separate the patients with RV-FAC equal to or greater than 35% from those with RV-FAC smaller than 35%. TAPSE by CMM had similar specificity and sensitivity (98.5% and 53.8%, respectively [P < 0.001]) for a cutoff point of 17.5 mm. Conclusions: The results of the present study on patients with a variety of cardiovascular diseases showed that TAPSE by AMM had similar specificity and sensitivity compared to TAPSE by CMM for discriminating normal from abnormal RV functions based on RVFAC.