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].