Right Ventricular Strain: Clinical Application

For many decades assessment of right ventricular function has been a challenge, with several parameters available for use but none being reliable and accurate. The oldest and still the most widely used is tricuspid annular plane systolic excursion (TAPSE), which has its own technical limitations. Later, the arrival of tissue Doppler imaging provided an additional parameter, with its measurement of peak systolic velocity of the lateral annulus of the tricuspid annulus, but this being angle-dependent also showed limited utility, like TAPSE. The advent of speckle-tracking echocardiography over the last decade, which is not angle-dependent and less load dependent, heralded a new way of looking at the RV function landscape. Despite some technical challenges, it has shown itself to be acceptable and has increasingly been used as a reliable parameter in clinical settings over the last few years. It has been recommended as a parameter with high feasibility and reproducibility.