ReviewTAPSE: An old but useful tool in different diseases
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TAPSE and the right ventricle
Since the echocardiography was born, the right ventricle (RV) was considered less relevant in cardiac diseases than its left counterpart, and it was regarded as the neglected or forgotten chamber of the heart because of its retrosternal position, its very complex structure and shape. Moreover the RV and the left ventricle (LV) are intimately connected through the interventricular septum, sharing common fibers that encircle both ventricles, which justifies the functional interdependence between
Right ventricular anatomy and physiology
Considering the parasternal short axis (PSAX), the RV has a crescent shape that wraps around the LV.
The gross anatomy of the RV differs so much from the one of the LV: the RV has a complex geometry loosely resembling that of a pyramid that wraps around the left ventricle (LV) [4] and it has an anterior, inferior, and lateral (free) wall (RVFW). We can also distinguish three different parts: the inflow, the apex (the body) and the outflow tract (RVOT). The inflow and the outflow portions
The assessment of right ventricular function and the measurement of TAPSE
RV function is an important component of the overall heart function with prognostic value in predicting symptomatic limitation and outcome in different cardiovascular diseases, including heart failure, non-ischemic cardiomyopathy, and pulmonary hypertension [12], [13], [14]. Unfortunately the echocardiographic calculation of RV volume and RV ejection fraction remains hampered by the complex RV geometry [2], [15] and the lack of a good geometric model allowing the calculation of the right
TAPSE and heart failure with preserved ejection fraction (HEPEF)
Much attention has been paid to left ventricular (LV) dysfunction either with a reduced (systolic; S-HF) or preserved (HFPEF) LV ejection fraction (LVEF).
Understanding the prevalence and the clinical implications of altered RV function in large HF cohorts is hindered by the challenge to quantitatively assess the RV structure and function [2], [4].
It is difficult to determine whether right ventricular dysfunction (RVD) in HFpEF is the reflection of myocardial dysfunction, afterload-mismatch,
Conclusions
To the best of our knowledge, in daily clinical practice the echocardiographic assessment of RV function is essential Most echo- and Doppler-derived variables related to systolic function provide clinical insights and relevant prognostic indications. Non-invasive measurement of TAPSE by transthoracic echocardiography should be included as part of the routine work-up in patients hospitalized for HF.
However, TAPSE has demonstrated some relevant limitations, particularly in some clinical contexts
Conflict of interest
The authors report no relationships that could be construed as a conflict of interest.
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