Tricuspid annular plane systolic excursion (TAPSE)
TAPSE is a highly reproducible, easy obtainable parameter [17] of RV longitudinal function, which is acquired by placing M-mode at the lateral tricuspid annulus in the apical 4-chamber view and by measuring the vertical excursion of the annulus in millimetres (mm). A value of TAPSE < 16 mm reflects RV systolic dysfunction [16, 18]. The main limitations are that TAPSE is angle- and load-dependent [18] and that it only reflects the longitudinal function, neglecting the contribution of the outflow tract to the contraction of the RV [19], potentially leading to an underestimation or overestimation of global RV systolic performance [15].
Ghio et al. showed that TAPSE 14 mm is an independent predictor of death or emergency cardiac transplantation in patients with congestive HF [20], while Venner et al. found a TAPSE 15 mm to be an independent predictor of major adverse cardiovascular events (MACE) in patients with idiopathic dilated cardiomyopathy (DCM) [21]. Several other studies showed that TAPSE is an independent predictor of all-cause mortality in patients with HF [22-24]. The prognostic ability of TAPSE appears to be improved when combined with the echocardiographic estimation of pulmonary artery systolic pressure (PASP). As shown by Ghio et al. [9], a PASP ≥ 40 mm Hg combined with TAPSE 14 mm predict unfavourable outcomes in patients with HF, regardless of its aetiology (ischaemic or non-ischaemic).