TAPSE (RV systolic function) Calculator

Explanation — TAPSE, physiology, clinical meaning, and prognostic context TAPSE (tricuspid annular plane systolic excursion) quantifies the longitudinal displacement of the lateral tricuspid annulus toward the apex during systole and therefore serves as a simple surrogate of right ventricular longitudinal systolic function. It is measured in M-mode aligned with the lateral tricuspid annulus in the apical four-chamber view and reported in millimetres (mm). Because the right ventricle contracts predominantly in the longitudinal axis, TAPSE correlates with more global measures of RV systolic function and with outcomes in multiple disease states; conventionally a value <17 mm is considered suggestive of impaired RV systolic function according to ASE/consensus recommendations.

Nevertheless, TAPSE is angle-dependent and sensitive to cardiac translation, and therefore its interpretation must be integrated with other imaging indices (e.g., RV fractional area change, RV free-wall longitudinal strain) and the clinical scenario. When pulmonary pressures are elevated or when pulmonary vascular load is a central driver of RV dysfunction, combining TAPSE with an estimate of pulmonary artery systolic pressure (PASP, often estimated by TR velocity + RAP) to calculate the TAPSE/PASP (or TAPSE/sPAP) ratio improves risk stratification: several cohorts of heart failure, pulmonary hypertension, and acute heart failure patients have shown that lower TAPSE/PASP ratios (reported thresholds vary by population — commonly ~0.30–0.36; very low values such as <0.18 have been described in advanced PAH cohorts) are associated with worse outcomes. Use these metrics as part of a comprehensive assessment rather than as sole arbiters of management decisions.

References 1. Lang RM, Badano LP, Mor-Avi V, et al. Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging.

J Am Soc Echocardiogr. 2015;28(1):1–39 — guideline summary with TAPSE cut-offs. 2.

Latest ASE guideline/consensus on echocardiographic assessment of the right heart — technical notes and normal values (ASE guidance PDF 2025) — states normal M-mode TAPSE >1.70 cm and warns TAPSE should not be used in isolation. 3. Studies on TAPSE/PASP (TAPSE/sPAP) and prognosis: multiple cohorts show that a lower TAPSE/PASP ratio is associated with higher mortality and rehospitalisation; example thresholds reported include ~0.33–0.36 for worse prognosis in heart failure cohorts and much lower thresholds (e.g., <0.18) in advanced pulmonary arterial hypertension.

Representative studies and reviews: Bok Y et al., J Cardiovasc Imaging 2023; Palacios-Moguel et al. 2025; Fauvel et al. 2024.

4. State-of-the-art reviews on RV assessment emphasizing TAPSE limitations and prognostic role: Hameed A et al., 2023; Wu VCC et al., 2018.