Aim: To evaluate if tricuspid annular plane systolic excursion (TAPSE) affects exercise tolerance and exercise recovery after exercise training (ET) , in patients with heart failure (HF) undergoing ET.
Methods: Fifty patients (median age: 67.8±5.9 years, EF 50.2±8.5), male /female = 42/8 were enrolled. All subjects attended an aerobic ET program three times per week for 12 weeks at 60-70% of heart rate reserve. Before starting ET program each patient underwent echocardiography evaluation, N-terminal-pro- BNP(NT-pro-BNP) assessment and 6MWT. NT-pro-BNP and 6MWT were repeated at the end of the ET program. Patients were divided into two groups according to the mean value of TAPSE (19.4mm).
Results: Twenty-three out of fifty (46%) patients had TAPSE <19. At baseline patients with TAPSE <19 had higher levels of NT-pro-BNP (491.9±131 vs 283.1±91; p <0.05) and slightly lower LVEF than patients with TAPSE >19 (47.2±10 vs 52.1±6 p >0.05). Distance walked at baseline 6MWT was lower in the group with TAPSE <19 compared to TAPSE >19 (420.2±90 vs 446.7±61 p >0.05). After training NT-pro-BNP levels decreased in both groups without significant intergroups differences. Distance walked at 6MWT increased in both groups but there was a lower increase in the group with TAPSE <19 (+20.3%) compared to TAPSE >19 (+27.5%). TAPSE was inversely related to distance walked at baseline 6MWT (r 0.32. p 0.04). NTpro- BNP and EF were poorly related to the performance at 6MWT.
Conclusion: TAPSE seems to be a valid alternative to the invasive hemodynamic evaluation, for exploring the relation between RV function and exercise tolerance in HF subjects undergoing ET.
