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Right Ventricular Systolic Function

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The right ventricle (RV) is no longer the forgotten chamber as studies have shown that critically ill patients with dysfunction are high risk for mortality. Right ventricular failure can result from elevated pulmonary pressures, excessive preload, and myocardial dysfunction. In this chapter, we discuss measures of systolic function. In Chap. 11, assessments of diastolic function are described. There are several easy ways to evaluate RV systolic function from transannular plane systolic excursion (TAPSE) with M-mode to systolic velocity with tissue Doppler imaging (TDI) and simply systematically visualizing the RV in different windows.


  • Right ventricular function
  • Right heart
  • Tricuspid annular plane systolic excursion

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  • DOI: 10.1007/978-3-030-74687-2_12
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Fig. 1
Fig. 2
Fig. 3
Fig. 4


AP 4:

Apical 4 Chamber View

IC :

Isovolumetric contraction

LV :

Left ventricle


Parasternal Short Axis View


Parasternal Long Axis View

RV :

Right ventricle


Systolic wave with tissue Doppler imaging


Tricuspid annular plane systolic excursion


Tissue Doppler imaging

Suggested Reading

  • Aloia E, Cameli M, et al. TAPSE: an old but useful tool in different diseases. Int J Cardiol. 2016;225:177–83.

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  • Hori Y, Kano T, Hoshi F, Higuchi S. Relationship between tissue Doppler-derived RV systolic function and invasive hemodynamic measurements. Am J Physiol Heart Circ Physiol. 2007;293(1):H120–5. Epub 2007 Feb 23.

    CAS  CrossRef  PubMed  Google Scholar 

  • Lang RM, Badano LP, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015;28(1):1–39.e12.

    CrossRef  PubMed  Google Scholar 

  • Rudski LG, Lai WW, Afilalo J, Hua L, Handschumacher MD, Chandrasekaran K, Solomon SD, Louie EK, Schiller NB. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr. 2010;23(7):685–713; quiz 786-8.

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Correspondence to Alexis Salerno .

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1 Electronic Supplementary Material

This video shows the D-Sign on the parasternal short axis view (MP4 4810 kb)

This video shows RV dysfunction on the apical 4 chamber view (MP4 2055 kb)

This video shows progressive RV dysfunction (MP4 39494 kb)

This video shows the cursor placement for TAPSE (MP4 6178 kb)

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Salerno, A. (2021). Right Ventricular Systolic Function. In: Salerno, A., Haase, D.J., Murthi, S.B. (eds) Atlas of Critical Care Echocardiography. Springer, Cham.

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