Published: 2022-11-24

Evaluation of foetal tricuspid annular plane systolic excursion with conventional m-mode ultrasound in normal pregnancy

Peter Chibuzor Oriji, Enefia Kelvin Kiridi, Datonye Christopher Briggs, Johnpatrick Uchenna Ugwoegbu, Akaninyene Eseme Ubom, Addah Abegnigo Ojanerohan, Isaac Joel Abasi, Bosrotsi Panebi, Chioma Okechukwu, Adesina Adedotun Daniel


Background: Foetal tricuspid annular plane systolic excursion (fTAPSE) in-utero helps in the evaluation of the right foetal cardiac function, which is key in the early diagnosis of congenital heart defects and abnormalities. Objectives of the study was to assess foetal TAPSE in the second half of normal pregnancy, establish reference ranges for this measurement in our environment, and to determine the relationship of foetal TAPSE with gestational age and estimated foetal weight.

Methods: This descriptive cross-sectional study was conducted between March 2022 and August 2022 at the Obstetric Units and Radiology Departments of the two tertiary facilities, one secondary facility and one radiodiagnostic facility in Bayelsa State, Nigeria. Consenting pregnant women presenting to the antenatal clinic during the second half of pregnancy were consecutively included. An obstetric ultrasound scan was performed transabdominally. Data were analysed using SPSS version 25.

Results: There was a very strong, positive and significant relationship between fTAPSE and gestational age (ɼ=0.81; p=0.001); and between fTAPSE and estimated foetal weight (ɼ=0.79; p=0.001). The mean fTAPSE and standard deviation from the 20th to the 23rd week of gestation were 2.10±1.11 mm, 2.43±0.95, 2.74±0.84 mm and 2.94±0.70 mm, showing a gradual increase in mean fTAPSE as gestational age increases.

Conclusions: Our study revealed that there was a significant relationship between fTAPSE and gestational age; and between fTAPSE and estimated foetal weight, which correlates with published data around the globe.




Foetal TAPSE, Foetal cardiac function, Gestational age, Estimated foetal weight

Full Text:



Feger J. Tricuspid annular plane systolic excursion. 2021. Available at: Accessed on 27 Aug, 2022.

Bravo-Valenzuela NJ, Peixoto AB, Nardozza LM, Souza AS, Araujo Júnior E. Applicability and technical aspects of two-dimensional ultrasonography for assessment of fetal heart function. Med Ultrason. 2017;19(1):94-101.

Gent R. Applied physics and technology of diagnostic ultrasound. Crookwell, New South Wales, Australia: Milner Publishing; 1997;388.

Lee-Tannock A, Hay K, Gooi A, Kumar S. Longitudinal Reference Ranges for Tricuspid Annular Plane Systolic Excursion and Mitral Annular Plane Systolic Excursion in Normally Grown Fetuses. J Ultrasound Med. 2020;39(5):929-37.

Aloia E, Cameli M, D’Ascenzi F, Sciaccaluga C, Mondillo S. TAPSE: An old but useful tool in different diseases. Int J Cardiol. 2016;225:177-83.

Dutta T, Aronow WS. Echocardiographic evaluation of the right ventricle: Clinical implications. Clin Cardiol. 2017;40(8):542-8.

Smolarek D, Gruchała M, Sobiczewski W. Echocardiographic evaluation of right ventricular systolic function: The traditional and innovative approach. Cardiol J. 2017;24(5):563-72.

Cruz-Lemini M, Crispi F, Valenzuela-Alcaraz B, Figueras F, Sitges M, Gómez O et al. Value of annular M-mode displacement vs tissue Doppler velocities to assess cardiac function in intrauterine growth restriction. Ultrasound Obstet Gynecol. 2013 Aug;42(2):175–81.

Messing B, Gilboa Y, Lipschuetz M, Valsky DV, Cohen SM, Yagel S. Fetal tricuspid annular plane systolic excursion (f-TAPSE): evaluation of fetal right heart systolic function with conventional M-mode ultrasound and spatiotemporal image correlation (STIC) M-mode. Ultrasound Obstet Gynecol. 2013;42(2):182-8.

Tedesco GD, De Souza Bezerra M, Barros FSB, Martins WP, Nardozza LMM, Mattar R et al. Fetal Heart Function by Tricuspid Annular Plane Systolic Excursion and Ventricular Shortening Fraction Using STIC M-Mode: Reference Ranges and Validation. Am J Perinatol. 2017;34(13):1354-61.

Araoye MO. Subjects Selection. In: Research Methodology with statistics for Health and Social sciences. Ilorin: Nathadex publishers. 2003;115-29.

Hadlock FP, Harrist RB, Sharman RS, Deter RL, Park SK. Estimation of fetal weight with the use of head, body, and femur measurements--a prospective study. Am J Obstet Gynecol. 1985 Feb 1;151(3):333-7.

Carvalho JS, O’Sullivan C, Shinebourne EA, Henein MY. Right and left ventricular long-axis function in the fetus using angular M-mode: Long-axis function in the fetus. Ultrasound Obstet Gynecol. 2001;18(6):619-22.

Gardiner HM, Pasquini L, Wolfenden J, Barlow A, Li W, Kulinskaya E et al. Myocardial tissue Doppler and long axis function in the fetal heart. Int J Cardiol. 2006;113(1):39-47.

Peixoto AB, Bravo-valenzuela NJ, Martins WP, Tonni G, Mattar R, Moron AF et al. Reference ranges for the fetal mitral, tricuspid, and interventricular septum annular plane systolic excursions (mitral annular plane systolic excursion, tricuspid annular plane systolic excursion, and septum annular plane systolic excursion) between 20 and 36 + 6 weeks of gestation. J Perinatal Med. 2020;48(6):601-8.

Koestenberger M, Nagel B, Ravekes W, Urlesberger B, Raith W, Avian A et al. Systolic Right Ventricular Function in Preterm and Term Neonates: Reference Values of the Tricuspid Annular Plane Systolic Excursion (TAPSE) in 258 Patients and Calculation of Z-Score Values. Neonatology. 2011;100(1):85-92.

Halimić M, Terzić S, Kadić A, Begić Z, Vukas E, Mišanović V et al. Right ventricular systolic longitudinal function in infants: correlation of TAPSE with gestational age and body weight. J Pediatr Neonatal Individualized Med. 2018;7(2):e070216.

Akintunde A. Right ventricular function in patients with heart failure in a cardiac clinic in Southwest Nigeria. Niger Med J. 2017;58(1):7. 19.

Shrout PE, Fleiss JL. Intraclass correlations: Uses in assessing rater reliability. Psychol Bull. 1979;86:420-8.

Costa-Santos C, Bernardes J, Ayres-de-Campos D, Costa A, Costa C. The limits of agreement and the intraclass correlation coefficient may be inconsistent in the interpretation of agreement. J Clin Epidemiol. 2011;64:264-9.

Fernandez S, Figueras F, Gomez O, Martinez JM, Eixarch E, Comas M, et al. Intra- and interobserver reliability of umbilical vein blood flow. Prenat Diagn. 2008;28:999-1003.

Figueras F, Fernández S, Hernández-Andrade E, Gratacós E. Umbilical venous blood flow measurement: accuracy and reproducibility. Ultrasound Obstetr Gynecol. 2008;32:587-91.