Right ventricle, IVC & PH probability

Flags RV size and systolic function indices against ASE/EACVI limits, grades RV systolic dysfunction (mild, moderate, severe) by TAPSE and fractional area change, grades RV dilatation by its size relative to the LV, estimates RA pressure from IVC diameter and collapse, and derives PASP, TAPSE/PASP coupling and the 2022 ESC/ERS echocardiographic probability of pulmonary hypertension.

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RV size

RV-focused apical 4-chamber view, end-diastole (ASE/EACVI 2015 upper limits)

RV basal diameter

Normal ≤ 41RV mid-cavity diameter

Normal ≤ 35RV base-to-apex length

Normal ≤ 83RVOT proximal diameter (PSAX)

Normal ≤ 35RV/LV basal diameter ratio

Normal ≤ 1.0

Grade of dilatation (RV relative to LV, apical 4-chamber)

RV systolic function

Enter any indices measured — each is flagged against its abnormal cut-off

TAPSE

Normal ≥ 17 · mild 13–16 · moderate 10–12 · severe < 10Tricuspid annular S′ (TDI)

cm/s

Abnormal < 9.5Fractional area change

Normal ≥ 35 · mild 25–34 · moderate 18–24 · severe < 18RV free-wall longitudinal strain

Abnormal if magnitude < 20RIMI / Tei index (TDI)

Abnormal > 0.543D RV ejection fraction

Abnormal < 45

IVC and RA pressure

Subcostal view, 1–2 cm from the RA junction, with a sniff

IVC maximal diameter

Dilated > 21IVC minimal diameter (sniff)

Used to calculate collapse

Secondary signs of raised RA pressure

TR velocity and signs of PH

2022 ESC/ERS: other signs count when present in ≥ 2 of categories A, B, C

Peak TR velocity

m/s

PASP = 4v² + RA pressure

Right heart assessment

Enter RV size, function, IVC or TR measurements.

References