Clinical Research in Cardiology

, Volume 100, Issue 1, pp 67–75

Tricuspid annular plane systolic excursion and right ventricular ejection fraction in pediatric and adolescent patients with tetralogy of Fallot, patients with atrial septal defect, and age-matched normal subjects

  • Martin Koestenberger
  • Bert Nagel
  • William Ravekes
  • Allen D. Everett
  • Hans Peter Stueger
  • Bernd Heinzl
  • Erich Sorantin
  • Gerhard Cvirn
  • Andreas Gamillscheg
Original Paper

DOI: 10.1007/s00392-010-0213-z

Cite this article as:
Koestenberger, M., Nagel, B., Ravekes, W. et al. Clin Res Cardiol (2011) 100: 67. doi:10.1007/s00392-010-0213-z



To determine whether TAPSE is an accurate marker of right ventricular (RV) systolic function in patients with tetralogy of Fallot (TOF) and patients with small atrial septal defect (ASD). The tricuspid annular plane systolic excursion (TAPSE) values were measured and compared with RV ejection fraction (EF).

Methods and results

A prospective study was conducted in pediatric and adolescent patients with TOF (n = 110), with isolated small secundum ASD (n = 200), and age-matched patients with normally structured heart. The TAPSE values showed a positive correlation with age in both patients with ASD and normal subjects. No significant difference of TAPSE values was seen in control subjects and age-matched ASD patients. The TAPSE was not decreased compared to normal subjects in eight infant TOF patients before corrective surgery. A reduction of TAPSE values with increasing time interval following corrective surgery was seen. After a mean of 7 years TAPSE values become significantly reduced compared to age-matched controls, being below the lower bound of the −2 SD.


In ASD patients the systolic RV function was preserved over the pediatric age group when compared to normal subjects. In contrast, although initially preserved, we found an impaired TAPSE with increasing postoperative period in our TOF patients.


Tricuspid annular plane systolic excursion Right ventricular systolic function Pediatric patients Tetralogy of Fallot 



Atrial septal defect


Body surface area


Ejection fraction


Left ventricle


End-diastolic volume


Tetralogy of Fallot


Standard deviation


Pulmonary regurgitation


Pulmonary artery


Right ventricle


Magnetic resonance imaging


New York Heart Association


Transannular patch


Tricuspid annular plane systolic excursion


Tricuspid regurgitation

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Martin Koestenberger
    • 1
  • Bert Nagel
    • 1
  • William Ravekes
    • 2
  • Allen D. Everett
    • 2
  • Hans Peter Stueger
    • 3
  • Bernd Heinzl
    • 1
  • Erich Sorantin
    • 4
  • Gerhard Cvirn
    • 5
  • Andreas Gamillscheg
    • 1
  1. 1.Division of Pediatric Cardiology, Department of PediatricsMedical University GrazGrazAustria
  2. 2.Division of Pediatric CardiologyJohns Hopkins University School of MedicineBaltimoreUSA
  3. 3.Data, Statistics and Risk AssessmentAustrian Agency for Health and Food SafetyGrazAustria
  4. 4.Division of Pediatric Radiology, Department of RadiologyMedical University GrazGrazAustria
  5. 5.Institute of Physiological Chemistry, Centre of Physiological MedicineMedical University GrazGrazAustria