Three-dimensional analysis of the tricuspid annular geometry in healthy subjects and in patients with different grades of functional tricuspid regurgitation

Cardiovascular Ultrasound

Research

Rita Kramena¹  Gintarė Bieliauskienė²  Diana Zakarkaitė²  Aleksejus Zorinas²  Ieva Kažukauskienė³  Antanas Mainelis⁴ 

[1] Center of Cardiology and Angiology, Vilnius University Hospital Santaros Klinikos, Santariskiu St. 2, 08661, Vilnius, Lithuania;Clinic of Cardiovascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, M. K. Čiurlionio 21, 03101, Vilnius, Lithuania;Department of Pathology, Forensic Medicine, Faculty of Medicine, Vilnius University, M. K. Čiurlionio 21, 03101, Vilnius, Lithuania;Faculty of Mathematics and Informatics, Vilnius University, Naugarduko 24, 03225, Vilnius, Lithuania;

关键词: Three-dimensional echocardiography;    Tricuspid valve;    Tricuspid regurgitation;    Tricuspid annulus;   

DOI  :  10.1186/s12947-023-00315-7

 received in 2023-04-16, accepted in 2023-09-04,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundAccurate sizing of the tricuspid valve annulus is essential for determining the optimal timing of tricuspid valve (TV) intervention. Two-dimensional (2D) echocardiography has limitations for comprehensive TV analysis. Three-dimensional (3D) imaging of the valve provides a better understanding of its spatial anatomy and enables more accurate measurements of TV structures.ObjectivesThe study aimed to analyze tricuspid annulus (TA) parameters in normal heart and in different grades of functional tricuspid regurgitation (TR); to compare TA measurements obtained by 2D and 3D echocardiography.MethodsOne hundred fifty-five patients (median age 65 years, 57% women) with normal TV and different functional TR grades underwent 2D and 3D transthoracic echocardiography. The severity of TR was estimated using multiparametric assessment according to the guidelines. Mid-systolic 3D TA parameters were calculated using TV dedicated software. The conventional 2D systolic TA measurements in a standard four-chamber view were performed.ResultsIn mid-systole, the normal TA area was 9.2 ± 2.0 cm2 for men and 7.4 ± 1.6 cm2 for women. When indexed to body surface area (BSA), there were no significant differences in the 3D parameters between genders. The 2D TA diameters were smaller than those measured in 3D. The ROC curve analysis identified that all 3D TA parameters can accurately differentiate between different functional TR grades. Additionally, the optimal cut-off values were identified for each TA parameter.ConclusionsGender, body size, and age have an impact on the TA parameters in healthy subjects. 2D measurements are smaller than 3D parameters. The reference values for 3D metrics according to TR severity can help in identifying TA dilation and distinguishing between different functional TR grades.Graphical Abstract

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

12888_2023_5142_Article_IEq3.gif

12888_2023_5142_Article_IEq2.gif

Fig. 1

Fig. 2

Fig. 1

Fig. 2

Fig. 3

Fig. 2

Fig. 1

40249_2023_1135_Article_IEq9.gif