Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2018 Jul;130(13-14):413-420.
doi: 10.1007/s00508-018-1330-3. Epub 2018 Mar 19.

Echocardiographic evaluation of the right heart

Matthias Schneider  1 , Thomas Binder  2
Affiliations
Review

Echocardiographic evaluation of the right heart

Matthias Schneider et al. Wien Klin Wochenschr. 2018 Jul.

Abstract

Symptoms of right ventricular failure include dyspnea, a reduction in exercise capacity, and fluid retention. Right ventricular (dys)function strongly influences functional state and survival. The right ventricle is directly involved in a variety of diseases. A thorough analysis of right ventricular size and function, as well as estimation of pulmonary artery pressures is an important part of every echocardiographic examination. This review analyses the most commonly used parameters for quantification of right ventricular function. It gives a practical approach for estimation of right ventricular size and function, as well as pulmonary artery pressure.

Keywords: 3D echocardiography; Longitudinal strain; Right ventricular function; TAPSE; Transthoracic echocardiography.

PubMed Disclaimer

Conflict of interest statement

M. Schneider and T. Binder declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Systematic evaluation of right ventricular size from four standardized transthoracic views and their normal values. a Proximal outflow tract parasternal long axis view; >30 mm abnormal, normal range 20–30 mm. b Proximal outflow tract parasternal short axis view; >35 mm abnormal, normal range 21–35 mm. c Distal outflow tract; >27 mm abnormal, normal range 17–27 mm. d Apical right ventricle at base; abnormal: >41 mm, normal range 25–41 mm. Apical right ventricle at mid-level; abnormal: >35 mm, normal range 19–35
Fig. 2
Fig. 2
Evaluation of right ventricular function: RV end-diastolic (panel a) and end-systolic (panel b) area for calculation of right ventricular fractional area change. Tricuspid annular plane systolic excursion (TAPSE) (panel c) and Tissue Doppler of the free lateral wall (S’) (panel d), longitudinal strain of the free lateral wall of the right ventricle (panel e), and transthoracic 3D reconstruction of the right ventricle (panel f)
Fig. 3
Fig. 3
Right atrial size in two patients with pulmonary hypertension. Patient A with decompensated right heart failure (RA volume 453 ml). Patient B with compensated clinical state (RA volume 60 ml)
Fig. 4
Fig. 4
Systematic evaluation of signs of pulmonary hypertension. Maximum jet velocity over tricuspid regurgitation (panels a and b). Diameter and respiratory change of inferior vena cava (panel c). Pulmonary valve acceleration time (panel d). Dilatation of the pulmonary artery (panel e) showing the pulmonary trunk in the parasternal short axis and panel f showing the right pulmonary artery from suprasternal angulation
See this image and copyright information in PMC

References

    1. Anavekar NS, et al. Two-dimensional assessment of right ventricular function: an echocardiographic-MRI correlative study. Echocardiography. 2007;24(5):452–456. doi: 10.1111/j.1540-8175.2007.00424.x. - DOI - PubMed
    1. Anavekar NS, et al. Usefulness of right ventricular fractional area change to predict death, heart failure, and stroke following myocardial infarction (from the VALIANT ECHO Study) Am J Cardiol. 2008;101(5):607–612. doi: 10.1016/j.amjcard.2007.09.115. - DOI - PubMed
    1. Austin C, et al. Echocardiographic assessment of estimated right atrial pressure and size predicts mortality in pulmonary arterial hypertension. Chest. 2015;147(1):198–208. doi: 10.1378/chest.13-3035. - DOI - PMC - PubMed
    1. Bellsham-Revell HR, et al. Subjective evaluation of right ventricular systolic function in hypoplastic left heart syndrome: how accurate is it? J Am Soc Echocardiogr. 2013;26(1):52–56. doi: 10.1016/j.echo.2012.09.020. - DOI - PMC - PubMed
    1. Blanchard DG, et al. Utility of right ventricular Tei index in the noninvasive evaluation of chronic thromboembolic pulmonary hypertension before and after pulmonary thromboendarterectomy. Jacc Cardiovasc Imaging. 2009;2(2):143–149. doi: 10.1016/j.jcmg.2008.10.012. - DOI - PubMed

LinkOut - more resources