Document Detail


Geometric determinants of functional tricuspid regurgitation: insights from 3-dimensional echocardiography.
MedLine Citation:
PMID:  16818811     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Tricuspid regurgitation (TR) is an important predictor of morbidity and mortality in heart failure. We aimed to examine the 3D geometry of the tricuspid valve annulus (TVA) in patients with functional TR, comparing them with patients with normal tricuspid valve function and relating annular geometric changes to functional TR. METHODS AND RESULTS: TVA shape was examined by real-time 3D echocardiography in 75 patients: 35 with functional TR and 40 with normal tricuspid valve function (referent group). The 3D shape of the TVA was reconstructed from rotated 2D planes, and the annular plane was computed by least-squares fitting. Annular area and mediolateral, anteroposterior, and high (superior)-low (inferior) distances were calculated. TR was assessed by vena contracta width. The normal TVA has a bimodal pattern (high-low distance=7.23+/-1.05 mm). High points were located anteroposteriorly, and low points were located mediolaterally. With moderate or greater TR (vena contracta width 5.80+/-2.62 mm), the TVA became dilated (17.24+/-4.75 versus 9.83+/-2.18 cm2, P<0.0001, TR versus referent), more planar with decreased high-low distance (4.14+/-1.05 mm), and more circular with decreased ratio of mediolateral/anteroposterior (1.11+/-0.09 versus 1.32+/-0.09, P<0.0001, TR versus referent). CONCLUSIONS: The normal TVA has a bimodal shape with distinct high points located anteroposteriorly and low points located mediolaterally. With functional TR, the annulus becomes larger, more planar, and circular. These changes in annular shape with TR have potentially important mechanistic and therapeutic implications for tricuspid valve repair.
Authors:
Thanh-Thao Ton-Nu; Robert A Levine; Mark D Handschumacher; David J Dorer; Chaim Yosefy; Dali Fan; Lanqi Hua; Leng Jiang; Judy Hung
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2006-07-03
Journal Detail:
Title:  Circulation     Volume:  114     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2006 Jul 
Date Detail:
Created Date:  2006-07-11     Completed Date:  2006-08-14     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  143-9     Citation Subset:  AIM; IM    
Affiliation:
Cardiac Ultrasound Laboratory, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
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MeSH Terms
Descriptor/Qualifier:
Arrhythmias, Cardiac
Echocardiography
Echocardiography, Three-Dimensional*
Heart / anatomy & histology
Heart Atria / anatomy & histology
Heart Failure / etiology,  ultrasonography
Humans
Image Processing, Computer-Assisted
Patient Selection
Tricuspid Valve Insufficiency / ultrasonography*
Grant Support
ID/Acronym/Agency:
K23HL004504/HL/NHLBI NIH HHS; R01 HL072265/HL/NHLBI NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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