| Geometric determinants of functional tricuspid regurgitation: insights from 3-dimensional echocardiography. | |
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MedLine Citation:
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PMID: 16818811 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article; Research Support, N.I.H., Extramural Date: 2006-07-03 |
Journal Detail:
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Title: Circulation Volume: 114 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2006 Jul |
Date Detail:
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Created Date: 2006-07-11 Completed Date: 2006-08-14 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
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Languages: eng Pagination: 143-9 Citation Subset: AIM; IM |
Affiliation:
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Cardiac Ultrasound Laboratory, Massachusetts General Hospital, Boston, Massachusetts 02114, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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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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