Clinical Utility and Limitations of TAPSE in Pediatric Echocardiography: A Narrative Review

Area of Science:

• Pediatric Cardiology
• Echocardiography
• Cardiovascular Physiology

Background:

• Tricuspid annular plane systolic excursion (TAPSE) is a common echocardiographic measure for assessing right ventricular (RV) longitudinal systolic function in pediatric patients.
• Its reliability can be affected by normal developmental changes and physiological variations in children.

Purpose of the Study:

• To assess the clinical utility, age-specific variations, and limitations of using TAPSE in pediatric populations.
• To provide guidance on interpreting TAPSE measurements across different pediatric age groups.

Main Methods:

• A comprehensive narrative literature review was performed using major scientific databases (PubMed, Scopus, Google Scholar).
• Included studies published between 1990 and 2025, focusing on TAPSE evaluation in individuals aged 0 to 18 years.

Main Results:

• Thirty-two studies were analyzed, indicating TAPSE correlates well with RV systolic function in older children and adolescents, with established reference values.
• In neonates and infants, TAPSE values are typically lower and more variable due to physiological transitions and altered loading conditions.
• TAPSE demonstrates clinical utility in conditions like pulmonary hypertension, congenital heart disease, cardiomyopathy, and post-cardiac transplant monitoring.

Conclusions:

• TAPSE is a practical and reproducible indicator of RV systolic function in children, especially those older than infancy.
• Caution and integration with other echocardiographic parameters are advised when interpreting TAPSE in infants.
• Combined indices, such as TAPSE/pulmonary artery systolic pressure (PASP), may enhance prognostic evaluations.