Right ventricular isovolumic acceleration
Myocardial acceleration during isovolumic contraction is usually obtained using TDI at the lateral tricuspid annulus in the apical 4-chamber view. It is calculated as the peak myocardial velocity during isovolumic contraction divided by the time needed to reach this velocity. While it has the advantage of being relatively load-independent [19], it has a large confidence interval around the normal values [18], hence it is not recommended for routine use and no reference value for this parameter has been proposed in the latest guidelines [16]. Consequently, its prognostic utility has not been broadly studied. However, Sciatti et al. found RV isovolumic acceleration to be a better predictor for cardiac death and rehospitalization in patients with HF and reduced LVEF than traditional parameters of RV systolic function such as TAPSE, RV FAC and S’ wave [39].