• First-line RV systolic function assessment on echocardiography
• Screening for RV dysfunction in pulmonary hypertension
• Risk stratification post-MI (especially inferior/RV infarction)
• Serial monitoring in HF, PH, and after lung transplant
• Prognostic indicator in acute decompensated HF

• Simple M-mode measurement; reproducible and operator-independent
• No contrast required; works in poor acoustic windows
• Correlates with RV EF from cardiac MRI
• ESC/ASE endorsed; part of routine echo protocols

• Obtained in apical 4-chamber view (M-mode)
• Cursor placed at lateral tricuspid annulus (not at RV free wall)
• Measure systolic displacement from annular position in diastole to systole
• Measured in mm; independent of image angle

• Must be lateral annulus (not at septum); septum shows reduced excursion by design
• Reported as single value; not averaged across cardiac cycles
• Angle-independent; true linear excursion measurement
• Reduced TAPSE in LV dysfunction does not signify primary RV dysfunction

• TAPSE <16 mm associated with HF readmission and mortality
• Independent predictor of mortality in acute MI and HF
• <11 mm indicative of severe RV dysfunction; consider mechanical support evaluation
• Serial TAPSE decline (>2 mm/year) suggests disease progression

• Normal RV systolic function; standard monitoring
• No RV-specific interventions required
• Reassess if clinical deterioration or new symptoms

• Assess for cause: PH, HF, RV infarction, PE, primary RV disease
• Serial echo monitoring every 6–12 months
• Optimize HF therapy; consider diuretics if volume overloaded
• Screen for PH with BNP/NT-proBNP and right heart catheter if indicated

• Urgent cardiology referral; assess for acute decompensation
• Consider inotropic support if cardiogenic shock
• Evaluate for MCS / transplant candidacy if advanced HF
• Aggressive PH-directed therapy if pulmonary hypertension present

TAPSE measurement has been used in echocardiography since the early 2000s, emerging from systolic RV functional assessment studies. Standardized by ASE and ESC guidelines; now considered part of fundamental RV assessment on every echocardiogram.