RV Assessment - TAPSE and S' — EECC MCQ

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ModerateCardiac ImagingRV Assessment - TAPSE and S'EECC

A 65-year-old man with an acute anterior MI and cardiogenic shock undergoes echocardiography. The RV is dilated with TAPSE of 10 mm and RV S' of 6 cm/s. What do these values indicate?

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Correct answer: D — Severe RV systolic dysfunction; TAPSE <17 mm and S' <9.5 cm/s are abnormal, and values this low indicate critical RV impairment

TAPSE (tricuspid annular plane systolic excursion) and RV S' (tissue Doppler systolic velocity of the tricuspid annulus) are the two most widely used echocardiographic measures of RV longitudinal systolic function. Normal values: TAPSE ≥17 mm, S' ≥9.5 cm/s (ASE/EACVI guidelines). Values of 10 mm and 6 cm/s respectively indicate severe RV systolic dysfunction, which in the context of anterior MI with cardiogenic shock suggests RV involvement (either from RV infarction, RV pressure overload from acute LV failure, or septal dysfunction). RV dysfunction in cardiogenic shock is an independent predictor of mortality. More comprehensive RV assessment includes RV fractional area change (FAC) and 3D RVEF.

Reference: ASE/EACVI Guidelines on Right Heart Assessment; ESC (2023): ACS Guidelines