Question about Echocardiogram report - Right ventricle TAPSE abnormal

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libermana

My Biography
Joined
Jun 28, 2022
Messages
18
Location
Charleston, SC
First the good news... On December 22nd, I had a successful surgical aortic valve replacement (Edwards 25 mm) for the second time (first was in 2014 with I believe was an Edwards 21 mm)) and results from yesterday's echocardiogram regarding that valve are excellent. However, I'm concerned about the section of the report relating to the right ventricle. The report reads "Right ventricle size is normal. Mildly reduced systolic function. TAPSE is abnormal". Right Ventricle Measurements - Dimensions: RVIDd 3cm, TAPSE: 1.5 cm (Range: 1.7)!: Function: RV Free Wall Peak S' 10 cm/s. I found it interesting and perhaps concerning that my cardiologist highlighted the TAPSE measurement and included an exclamation point (which I used red text). This is the first echocardiogram report that I've had over the past several years that showed any abnormalities regarding the right ventricle and am wondering about any short and long term concerns about the most recent report? I'm 71 years old, a borderline diabetic but otherwise in excellent health as prior to my recent surgery went to the gym 3 to 4 times a week lifting weights and doing an hour of cardio. I'm under weight restrictions currently but am now up to walking 3 miles daily at a brisk/aerobic pace. I've tried researching TAPSE abnormalities on line but have found the literature confusing and concerning. I've read terms such as "congenital heart disease", "mortality", etc. and am wondering if this echocardiogram report should raise concerns about my longevity? Also, are there any treatments, medications, etc. should the mildly reduced systolic function worsen? The new valve is 4 mm larger and am curious if that is a factor in decreased systolic functioning? My follow up with my cardiologist isn’t until next week so I’d appreciate The thoughts of forum readers.Thanks in advance!
 
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Hey! I'm really glad to hear that your AVR was a success.

I'm not qualified to speak on the exact ramifications/details of TAPSE measurements. However, broadly speaking, I really relate to the experience of seeing an abnormal reading on an echo and it causing concern and lots of questions! It really does feel like a blessing and a curse sometimes to get the numerical results early, especially when the measurement is just below a cutoff point like in your situation.

My thoughts are:

- A single non-normal measurement can definitely be meaningful, but it isn't the only thing that matters. Context is important and I'm sure if your cardiologist thinks this abnormal reading is significant, they will do proper follow-up and provide the necessary treatment if something else does need treating. Chest Echocardiograms can have a a surprising amount of difference in measurements between observers and other variables, so I'm sure due diligence will be done.

- From my experience, a lot of these automated systems will flag abnormal values somehow on their own. So the exclamation mark may have just been added by the automated system to flag an abnormal measurement?

- Important to remember when reading studies online, is that the studies try to target a specific population of people. The conclusions that they come to for that population may not apply to you or may apply only in part. Given the context that you have had a successful AVR and are recovering well and otherwise healthy and active, I think that's a very good sign in the big picture sense.

Sorry I couldn't offer more specific info, and I wish you the best <3
 
I would never say "don't worry" when it comes to ones health and the follow-up of anything out of the ordinary. However, you only had surgery a little over a month ago. The heart typically goes through some changes as you recover and as it finds normalcy in it's new condition. ie. larger valve perhaps.

I did find this article that you may want to review. Good luck and please keep us updated on what you discover.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6343576/#:~:text=Results,up (p = 0.003).
 
libermana said:
First the good news... On December 22nd, I had a successful surgical aortic valve replacement (Edwards 25 mm) for the second time (first was in 2014 with I believe was an Edwards 21 mm)) and results from yesterday's echocardiogram regarding that valve are excellent. However, I'm concerned about the section of the report relating to the right ventricle. The report reads "Right ventricle size is normal. Mildly reduced systolic function. TAPSE is abnormal". Right Ventricle Measurements - Dimensions: RVIDd 3cm, TAPSE: 1.5 cm (Range: 1.7)!: Function: RV Free Wall Peak S' 10 cm/s. I found it interesting and perhaps concerning that my cardiologist highlighted the TAPSE measurement and included an exclamation point (which I used red text). This is the first echocardiogram report that I've had over the past several years that showed any abnormalities regarding the right ventricle and am wondering about any short and long term concerns about the most recent report? I'm 71 years old, a borderline diabetic but otherwise in excellent health as prior to my recent surgery went to the gym 3 to 4 times a week lifting weights and doing an hour of cardio. I'm under weight restrictions currently but am now up to walking 3 miles daily at a brisk/aerobic pace. I've tried researching TAPSE abnormalities on line but have found the literature confusing and concerning. I've read terms such as "congenital heart disease", "mortality", etc. and am wondering if this echocardiogram report should raise concerns about my longevity? Also, are there any treatments, medications, etc. should the mildly reduced systolic function worsen? The new valve is 4 mm larger and am curious if that is a factor in decreased systolic functioning? My follow up with my cardiologist isn’t until next week so I’d appreciate The thoughts of forum readers.Thanks in advance!
Click to expand...
Better to wait till next week to talk to your doctor. For we are not doctors nor Cardiologists.
 
I just had my aortic valve replaced (On-x mechanical) in Sep, 2023. The first couple months I also had some test results that were not perfect. I have learned to make sure the medical team has the relevant information (test results, my summary of how I am feeling, etc). Then I must relax and focus on what I control: sleep, good diet, appropriate exercise, staying in contact with family and friends, etc.

You can do this!
 
Deidra said:
Hey! I'm really glad to hear that your AVR was a success.

I'm not qualified to speak on the exact ramifications/details of TAPSE measurements. However, broadly speaking, I really relate to the experience of seeing an abnormal reading on an echo and it causing concern and lots of questions! It really does feel like a blessing and a curse sometimes to get the numerical results early, especially when the measurement is just below a cutoff point like in your situation.

My thoughts are:

- A single non-normal measurement can definitely be meaningful, but it isn't the only thing that matters. Context is important and I'm sure if your cardiologist thinks this abnormal reading is significant, they will do proper follow-up and provide the necessary treatment if something else does need treating. Chest Echocardiograms can have a a surprising amount of difference in measurements between observers and other variables, so I'm sure due diligence will be done.

- From my experience, a lot of these automated systems will flag abnormal values somehow on their own. So the exclamation mark may have just been added by the automated system to flag an abnormal measurement?

- Important to remember when reading studies online, is that the studies try to target a specific population of people. The conclusions that they come to for that population may not apply to you or may apply only in part. Given the context that you have had a successful AVR and are recovering well and otherwise healthy and active, I think that's a very good sign in the big picture sense.

Sorry I couldn't offer more specific info, and I wish you the best <3
Click to expand...
 
Hi Deidra,
Just a quick note to thank you for your thoughtful reply and insights. I did receive a quick note from my cardiologist regarding my echo report and he simply said that "the valve is working great"! He didn't make any mention of the TAPSE measurement so that provided some relief. I have an appointment with him on Wednesday so I will definitely bring up my questions then. Again thanks and good luck!
Art
 
Mark Miller said:
I just had my aortic valve replaced (On-x mechanical) in Sep, 2023. The first couple months I also had some test results that were not perfect. I have learned to make sure the medical team has the relevant information (test results, my summary of how I am feeling, etc). Then I must relax and focus on what I control: sleep, good diet, appropriate exercise, staying in contact with family and friends, etc.

You can do this!
Click to expand...
Hi Mark,
Thanks for your reply. Your advice is well-taken! Wishing you all the best with your new valve :)
Art
 
Survived03 said:
I would never say "don't worry" when it comes to ones health and the follow-up of anything out of the ordinary. However, you only had surgery a little over a month ago. The heart typically goes through some changes as you recover and as it finds normalcy in it's new condition. ie. larger valve perhaps.

I did find this article that you may want to review. Good luck and please keep us updated on what you discover.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6343576/#:~:text=Results,up (p = 0.003).
Click to expand...
Hi Survived,
Thanks for your reply and for sharing the article. I did find the results somewhat encouraging albeit the sample size was small and there was no differentiation in types of valve surgery. After my follow-up with my cardiologist, I will share his thoughts. Again, thanks and best of luck :)
Art
 
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