Fax +41 61 306 12 34 E-Mail karger@karger.ch www.karger.com Original Paper Neonatology 2011;100:85–92 DOI: 10.1159/000322006 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 Martin Koestenberger   a Bert Nagel   a William Ravekes   e Berndt Urlesberger   b Wolfgang Raith   b Alexander Avian   c Verena Halb   a Gerhard Cvirn   d Peter Fritsch   a Andreas Gamillscheg   a Divisions of a Pediatric Cardiology and b Neonatology, Department of Pediatrics, c  Institute for Medical Informatics, Statistics and Information, d Institute of Physiological Chemistry, Center of Physiological Medicine, Medical University Graz, Graz, Austria; e Division of Pediatric Cardiology, Johns Hopkins University School of Medicine, Baltimore, Md., USA correlated: Pearson’s correlation coefficient was 0.93 for week of gestation – TAPSE (p ! 0.001), 0.93 for week of gesta- tion – birth weight (p ! 0.001), and 0.89 for birth weight – TAPSE (p ! 0.001). There was no statistically significant differ- ence of normal TAPSE values between female and male pa- tients (p = 0.987). Conclusion: Z-scores of TAPSE values were calculated and percentile charts were established to serve as reference data for ready application in preterm and term ne- onates with structurally normal hearts and with congenital heart disease in the future. Copyright © 2011 S. Karger AG, Basel Introduction During pregnancy the right ventricle (RV) is the dom- inant ventricle [1]. It has been shown that the RV has a larger volume than the left ventricle (LV) [1, 2]. After birth the LV output exceeds the RV output [3]. In the first 2 days of life the RV volume decreases in healthy neonates [4]. In ventilated neonates it has been shown that RV volumes decrease, while RV ejection fraction (RVEF) increases in Key Words Tricuspid annular plane systolic excursion  Right ventricular systolic function  Preterm neonates  Term neonates  TAPSE, reference values  Birth weight, TAPSE  M-mode  Z-score Abstract Background: The tricuspid annular plane systolic excursion (TAPSE) is an echocardiographic measurement to assess right ventricular systolic function in adults and children. Ob- jective: We determined growth- and birth weight-related changes of TAPSE to establish reference values in preterm and term neonates. Methods: A prospective study was conducted in a group of 258 preterm and term neonates (age: 25+0 to 40+6 weeks of gestation, birth weight: 530– 4,200 g). Results: The TAPSE ranged from a mean of 0.44 cm (Z-score 82: 0.30–0.59 cm) in preterm neonates in the 26th week of gestation to 1.03 cm (Z-score 82: 0.85–1.21 cm) in term neonates in the 41st week of gestation. The TAPSE val- ues increased in a linear way from the 26th to 41st week of gestation. TAPSE, week of gestation and weight are strongly Received: May 27, 2010 Accepted after revision: October 11, 2010 Published online: January 26, 2011 Martin Koestenberger, MD Department of Pediatrics, Medical University Graz Auenbruggerplatz 30 AT–8036 Graz (Austria) Tel. +43 316 385 2605, E-Mail Martin.Koestenberger  @  medunigraz.at © 2011 S. Karger AG, Basel 1661–7800/11/1001–0085$38.00/0 Accessible online at: www.karger.com/neo