TAPSE measures the longitudinal movement of the lateral tricuspid annular plane during systole.

In the apical 4 view, align the cursor on the lateral tricuspid annulus.

Using M-Mode measure the peak distance of the tricuspid annulus from end-diastole to the end of systole.


TAPSE less than 17 mm suggests decreased RV systolic function.


Do not use TAPSE with poor 2D visualization of right heart as M-Mode relays on good 2D images.

Using appropriate gain can decrease noise artifact.

It is very important to align the cursor properly with the annular longitudinal excursion as TAPSE is angle dependent.

Compare at least 5 cardiac cycles for the most accurate measurement.

Make sure to use cardiac exam or presets. If using abdominal imaging the heart will look dysfunctional.


Figure 1 - A4C View for TAPSE

Figure 2 - Normal TAPSE

Figure 3 - Decreased TAPSE

Figure 4 - Severely Decreased TAPSE


Lang, Roberto M., 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.” European Heart Journal-Cardiovascular Imaging 16.3 (2015): 233-271.

Aloia, Elio, et al. “TAPSE: an old but useful tool in different diseases.” International journal of cardiology 225 (2016): 177-183.