Table 1.

Advantages and limitations of one- and two-dimensional analysis techniques for right ventricular functional assessment.

	Definition	Advantages	Limitations
Doppler-derived tricuspid lateral annular systolic velocity (S’)	Assessment of the longitudinal excursion velocity of the lateral tricuspid annulus	•Reproducible •Easy to perform •Correlated with radionuclide angiography for functional discrimination •Validated in population-based studies •Does not depend on 2D image quality •Minimal required post-processing	•Assumes regional function is representative of the entire chamber •Angle dependent •Lack of normative data across sex and age
Tricuspid annular systolic excursion (TAPSE)	Measurement of longitudinal displacement of the tricuspid annulus in systole	•Reproducible •Reduced dependence on image quality •Correlated with Simpson's biplane right ventricular ejection fraction •Easy to perform •Minimal required post-processing	•Assumes regional function is representative of the entire chamber •Angle dependent •Varies with loading conditions
Free-wall and global longitudinal strain (FWS & 4CHLS respectively)	Percentage of myocardial shortening in the longitudinal plane	•Accounts for several RV segments •Correlated with CMR assessments •Feasible despite abnormal RV geometry •Load independent	•Angle dependent •High degree of variability across platforms •Requires post-processing with limited accessibility •Lack of normative data •Poor signal-to-noise ratio •Excludes RV outflow tract
Fractional area change (FAC)	Percentage difference between end systolic and end diastolic areas divided by end diastolic area	•Correlated with CMR assessments •Prognostic for heart failure, stroke, and death	•Excludes outflow tract and most of the RV body •High inter-observer variability •Varies with loading conditions •Tedious and time-consuming
Myocardial performance index (MPI)	Summation of RV iso-volumetric contraction and relaxation times divided by the RV ejection time	•Accounts for systolic and diastolic function •Well validated in healthy patients •Feasible despite abnormal RV geometry •Reduced dependence on image quality	•Reduced accuracy in the setting of tachycardia, irregular heart rhythms, and elevated RA pressures