Tricuspid Annular Plane Systolic Excursion (TAPSE)
Tricuspid Annular Plane Systolic Excursion (TAPSE)
1. What is TAPSE?
TAPSE stands for Tricuspid Annular Plane Systolic Excursion. It is an echocardiographic measure of right ventricular longitudinal function.
2. Clinical Significance
TAPSE is used to assess right ventricular (RV) systolic function and is especially important in heart failure and pulmonary hypertension patients.
3. Measurement Method
It is measured using M-mode echocardiography in the apical 4-chamber view.
4. Normal TAPSE Value
A TAPSE ≥16 mm is considered normal. Values below this suggest RV systolic dysfunction.
5. Severe RV Dysfunction
TAPSE <10 mm is typically associated with severe right ventricular systolic dysfunction.
6. Relevant Echocardiographic View
TAPSE is assessed from the apical 4-chamber view focused on the lateral tricuspid annulus.
7. RV Function Indicator
It reflects the longitudinal contraction of the right ventricle—important in many cardiopulmonary diseases.
8. Application in Pulmonary Embolism
TAPSE is often used to assess RV function in acute pulmonary embolism and guides severity/risk stratification.
9. Use in Pulmonary Hypertension
TAPSE is a powerful prognostic marker in pulmonary hypertension, helping monitor RV function over time.
10. Prognostic Value
Lower TAPSE values correlate with worse outcomes in various cardiovascular diseases.
11. Beat Averaging
In patients with atrial fibrillation, TAPSE should be averaged over multiple cardiac cycles for accuracy.
12. Combined Assessment
TAPSE is often paired with RV S’ (Tissue Doppler) for comprehensive assessment of RV systolic function.
13. Limitation in RV Pacing
TAPSE may overestimate RV function in patients with right ventricular pacing due to abnormal annular motion.
14. Independent of Volume
TAPSE is relatively independent of preload and afterload, making it a stable RV function marker.
15. Used in Emergency Protocols
TAPSE is included in emergency echo protocols like FoCUS, RUSH, and FATE exams.
16. Related Structures
TAPSE evaluates the systolic movement of the lateral tricuspid annulus towards the apex during systole.
17. Simplicity & Speed
TAPSE is fast, reproducible, and easy to learn, making it ideal for bedside use.
18. Not Load-Independent
Though relatively stable, extreme changes in preload or afterload can affect TAPSE values.
19. Ideal in RV Infarct
TAPSE is particularly useful in assessing dysfunction after RV myocardial infarction.
20. Not Useful in TR Severity Assessment
TAPSE alone does not evaluate severity of tricuspid regurgitation—it only assesses RV systolic performance.
TAPSE graph now includes:
Normal (≥16 mm) and abnormal (<16 mm) reference lines with labels.
Arrow markers indicating the TAPSE excursion (end-diastole to end-systole).
