The assessment of the right ventricle (RV) is in a continuos state of "work in progress". Parameters,
values and algorithm presented here may be interpreted differently in the future.

Due to complex RV morphology, a quantitative assessment of systolic RV function is not possible with established methods,
since a required cylindrical form is not available. Therefore, systolic RV function is assessed only qualitatively.
A regional or global RV dilatation must be documented, as well as the
diameter and respiratory behavior of the inferior vena cava.

It is not known if available parameters to assess diastolic LV function would have the same value
when assessing diastolic RV function. However, other have found its place, e.g. parameters for assessment of
global function (Tei-index) or longitudinal systolic function (TAPSE, TASV, RV-strain). A review
can be found at
Advances in Pulmonary Hypertension.

Parameters for quantitative assessment:
TAPSE, TASV, Tei-Index, LV-EI

The assessment of RV function starts with the measurement of RV dimentions and the
qualitative evaluation of its function.

Left:
the right ventricle appears normal in size and systolic function. Notice the smaller RV surface
compared to the LV (aprox. 1:2 to 1:3).

Right:
massive dilated RV with severely reduced systolic function.

Left:
TAPSE can be assessed with M-mode, measuring the distance of tricuspid annular
movement between end-diastole to end- systole.

Right:
the velocity of this move- ment can be measured with TDI.

Left:
color encoded tissue Doppler imaging (TDI).

Right:
Tei-index, also known as "myocardial
performance index" (MPI) can be assessed with PW- Doppler in RVOT and RV inflow, and
also with TDI, with the formula (a-b)/b.

Left:
ventricular interdependence can be clearly recognize here. The LV is impaired in its function
through a significant septal inden- tation.

Right:
eccentricity index (Lei), systolic and diastolic, is an im- portant parameter that can
be determined with the formula: Lei = D1/D2. Normal value = 1.

Assessment of RV function with 3D-echo

RV function can accurately be assessed with three-dimensional echocardiography. Requirements are:
a matrix-array ultrasound probe and a current software for offline analysis of 3D data.

Here some examples of examinations with 2D and 3D echocardiography.