Document Detail

Echocardiographic insights into atrial and ventricular mechanisms of functional tricuspid regurgitation.
MedLine Citation:
PMID:  17161077     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The etiology of functional tricuspid regurgitation (TR) is thought to be annular dilatation and tethering of tricuspid valve (TV) leaflets. However, mechanisms of leaflet tethering are incompletely understood. The purpose of this study was therefore to investigate the relationships between TV annular dilatation and leaflet tethering with the severity of functional TR and to investigate factors that influence these TV deformations. METHODS: Two hundred forty-five patients with functional TR had 2-dimensional echocardiography. Echocardiographic investigations focused on the ventricles and on the TV. Ventricular measurements included left ventricular (LV) volume, right ventricular (RV) area, and RV spherical index. Valvular measurements included systolic TV annular dimension and apical displacement (tethering height), as well as severity of TR (vena contracta width). RESULTS: Tethering height (r2 = 0.25) was related to the severity of TR (P < .001). The RV and right atrium areas influenced both annular dimension and tethering height. However, LV ejection fraction and RV spherical index affected tethering height but not annular dimension. CONCLUSIONS: Tethering of TV leaflets, a determinant of functional TR, is associated with changes in right-sided cavity size as well as RV sphericity and LV function, emphasizing the impact of changes in ventricular geometry and function on the severity of functional TR.
Shota Fukuda; A Marc Gillinov; Jong-Min Song; Masao Daimon; Vorachai Kongsaerepong; James D Thomas; Takahiro Shiota
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  152     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2006-12-12     Completed Date:  2007-01-08     Revised Date:  2007-07-02    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1208-14     Citation Subset:  AIM; IM    
Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
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MeSH Terms
Aged, 80 and over
Heart / physiopathology*
Heart Atria
Heart Ventricles
Medical Records
Middle Aged
Severity of Illness Index
Sternum / ultrasonography
Stroke Volume
Tricuspid Valve / physiopathology,  ultrasonography
Tricuspid Valve Insufficiency / physiopathology*,  ultrasonography*
Ventricular Function, Left
Comment In:
Am Heart J. 2007 Jul;154(1):e9; author reply e11   [PMID:  17584545 ]

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