Evaluation of tricuspid annular plane systolic excursion measured by two-dimensional echocardiography in healthy dogs: repeatability, reference intervals, and comparison with M-mode assessment

Introduction: We sought to determine the feasibility, measurement variability, and within-day repeatability of tricuspid annular plane systolic excursion (TAPSE) measured by two-dimensional echocardiography (2D TAPSE), generate reference intervals for 2D TAPSE, assess agreement and correlation between 2D TAPSE and the conventional TAPSE measured by M-mode echocardiography (MM TAPSE), and to assess the ability of 2D TAPSE to track a drug-induced decrease in right ventricular (RV) function compared with MM TAPSE. Animals: Seventy healthy privately owned dogs of varying bodyweight. Methods: All dogs underwent a single echocardiogram to quantify RV function by both TAPSE methods. Ten dogs underwent a second echocardiogram 2–3 h after the first to assess within-day repeatability, and 20 different dogs underwent a second echocardiogram 3-h after atenolol (1 mg/kg per os (PO)). Intraobserver and interobserver measurement variabilities were assessed in 12 randomly selected studies using coefficients of variation. Statistical relationships between 2D TAPSE and bodyweight, gender, heart rate, and age were explored. Results: 2D TAPSE could be measured in all dogs. Coefficients of variation for repeatability and measurement variability were low (≤12%). Bodyweight-dependent reference intervals for 2D TAPSE were generated using allometric scaling. TAPSE methods were strongly correlated (r = 0.72; p<0.0001) but 2D TAPSE measured consistently less than MM TAPSE (−1.6 [2.2] mm) when analyzed by Bland–Altman's method. Both TAPSE methods were significantly (p≤0.014) reduced after atenolol but percent decrease in 2D TAPSE (−16.2 [9.3]%) was significantly greater (p=0.03) than MM TAPSE (−7.5 [13.8]%). Conclusions: Two-dimensional echocardiography TAPSE appears well suited for clinical assessment of RV function. The TAPSE methods should not be used interchangeably.