부산대학교 도서관

Background: Evaluation of right ventricular function remains a challenge despite current advances in echocardiographic techniques. This study investigates the effect of postural preload changes on tricuspid annular plane systolic excursion (TAPSE) and tissue Doppler imaging parameters in healthy volunteers.Methods: 24 healthy volunteers (age 19-67) were included in the study. Right ventricular inflow Doppler parameters, tissue Doppler parameters obtained from tricuspid lateral annulus and M-mode measurements for TAPSE from the lateral annulus were recorded. Same recordings were repeated after 45 degrees passive leg raising (PLR) and upright position.Results: Mean baseline TAPSE values were 2,59±0,33 cm. TAPSE values after PLR were similar to baseline values (2,54±0,29). TAPSE values in upright posture were significantly lower than baseline levels (2,19±0,27 cm, p<0,001). Tissue Doppler imaging revealed lower Sm levels upright when compared to baseline(11,09±2,71 cm/s ve 13,19±2,39 cm/s p=0,001), but the Sm levels did not change with PLR. Em velocities decreased upright (11,64 ±2,57 vs 9,12±2,93 cm/s p=0.003), but did not change after PLR. Myocardial acceleration during isovolumetric contraction (IVA) was not changed with postural maneuvers.Conclusion: TAPSE was not affected by mild preload changes induced by PLR but decreased after upright posture. This could be attributed to a more pronounced volume shift in the upright posture than with PLR.