• Assessment of RV function by echocardiography is quite challenging and is not devoid of limitations.
• Available options for RV systolic assessment are as follows:

Eye-Balling

Quantitative Measurements                                                           Normal

Tricuspid Annular Plane Systolic Excursion (TAPSE)                    >17mm

Tricuspid Annular Systolic Velocity (TASV or S’)                         >9.5 cm/sec.

Tricuspid Annular Diameter Index (TADI)                                     <21

Fractional Area Change (FAC)                                                        >35%

RV Myocardial Performance Index (MPI)                                      <.54

Tricuspid Annular Velocity Isovolumic Acceleration                     >2.2 m/s2

RV EF (by 3D)                                                                                52-68 %

RV global and regional strain                                                         -24-32 % 

• TAPSE is the most important parameter of RVF quantification. It quantifies the excursion of the tricuspid annular plane during systole. Normal value is >17 mm. It is simple, reproducible, reliable and has good correlation with radionuclide derived RVEF and RVFAC. Its limitations are that it is angle- and load-dependent. TAPSE <17mm predicts survival in pulmonary hypertension.
• Normal tricuspid systolic velocity by TDI is > 9.5 cm/sec. It is reliable, reproducible and correlates with RV Systolic function but is also angle and load dependent. TASV very well correlates with MRI measured RVEF.
• TASV correlates with TAPSE. Patients with pulmonary hypertension have decreased TAPSE and TASV.
• Tricuspid Annular Diameter Index (TADI) >21 mm/ sec indicates need for tricuspid annuloplasty in the setting of AVR/ MVR and decrease CV mortality. 
• FAC and longitudinal RV strain correlate well.
• RVMPI (TEI Index) is also an index for measurement of RV systolic and diastolic dysfunction. Normally, it is <0.54.
• Tricuspid  Isovolumic Acceleration normally >2.2 m/ sec. is also load-dependent.