Table 2. Echocardiographic Right Ventricular Parameters Significantly Correlated with Mortality in PH.

Echocardiographic Method	Echo View	Parameter indicating RV dysfunction	Prognosis
TAPSE	Apical 4-CH m-mode of lateral tricuspid annulus	< 18 mm	TAPSE < 18 mm associated with increased RV dysfunction, increased 1 and 2 yr mortality. Hazard ratio of 5.729.
Tei Index (also known as RV-MPI)	Apical 4-CH Pulse Doppler of TR regurgitation Tissue Doppler of lateral tricuspid annulus	>0.40 by Pulse Doppler > 0.55 by Tissue Doppler	5 year survival (free of death or lung transplantation):
			Tei index	5 yr survival
			<0.83	74%
			≥0.83	4%
			Hazard ratio of 1.3 for every 0.1 unit increase in Tei index128.
Peak systolic tricuspid lateral annular velocity (S’)	Pulse Doppler tissue imaging (DTI) of the tricuspid annulus	< 9.7 cm/sec	<9.7 cm/sec associated with abnormal RV contractility30.
RV fractional area change ( = [End-diastolic area] − [End-systolic area / End-diastolic area])	Apical 4-CH	< 35%	RVFAC significantly higher in 4 year survivors vs. nonsurvivors, (31%±9 vs. 24%±10)129.
Speckle Tracking Longitudinal Peak Systolic Strain (RV LPSS)	Apical 4-CH	More negative than (>)−19%	Survival rates (%)
			Yr	> −19% (higher strain)	< −19% (lower strain)
			1	93	77
			3	90	66
			5	90	55
			1% decrease (more negative) in LPSS = 13% increased risk of death.35

IVA, isovolumic acceleration; IVCv, isovolumic contraction velocity; MPI, myocardial performance index; RAP, right atrial pressure; RV, right ventricle; TAPSE, tricuspid annular plane systolic excursion; DTI, Doppler tissue imaging; TR, tricuspid regurgitation; 4CH, four chamber view; AS, Area Strain