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).