Donate Help Contact The AHA Sign In Home
American Heart Association
Circulation
Search: search_blue_button Advanced Search
Circulation. 2006;114:143-149
Published online before print July 3, 2006, doi: 10.1161/CIRCULATIONAHA.106.611889
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
114/2/143    most recent
CIRCULATIONAHA.106.611889v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow Request Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Ton-Nu, T.-T.
Right arrow Articles by Hung, J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Ton-Nu, T.-T.
Right arrow Articles by Hung, J.
Related Collections
Right arrow Congestive
Right arrow Valvular heart disease
Right arrow Echocardiography
Right arrow CV surgery: valvular disease
Right arrowRelated Article

(Circulation. 2006;114:143-149.)
© 2006 American Heart Association, Inc.


Imaging

Geometric Determinants of Functional Tricuspid Regurgitation

Insights From 3-Dimensional Echocardiography

Thanh-Thao Ton-Nu, MD, FRCP; Robert A. Levine, MD; Mark D. Handschumacher, BA; David J. Dorer, PhD; Chaim Yosefy, MD; Dali Fan, MD, PhD; Lanqi Hua, RDCS; Leng Jiang, MD; Judy Hung, MD

From the Cardiac Ultrasound Laboratory (T.-T.T.-N., R.A.L., M.D.H., C.Y., D.F., L.H., J.H.) and the Center for Biostatistics (D.J.D.), Massachusetts General Hospital, Boston, Mass; and Cardiology Medicine (L.J.), Baystate Medical Center, Springfield, Mass.

Correspondence to Judy Hung, MD, Cardiac Ultrasound Laboratory, Massachusetts General Hospital, Boston, MA 02114. E-mail Jhung{at}partners.org

Received July 18, 2005; de novo received January 2, 2006; revision received April 24, 2006; accepted May 10, 2006.

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.


 

CLINICAL PERSPECTIVE


Related Article:

Issue Highlights
Circulation 2006 114: 97. [Full Text]



This article has been cited by other articles:


Home page
J Am Coll CardiolHome page
S. H. Rahimtoola
The Year in Valvular Heart Disease.
J. Am. Coll. Cardiol., February 19, 2008; 51(7): 760 - 770.
[Full Text] [PDF]


Home page
ICVTSHome page
L. A. Bockeria, I. I. Skopin, and I. M. Tsiskaridze
Tricuspid valve prosthetic annuloplasty
Interactive CardioVascular and Thoracic Surgery, December 1, 2007; 6(6): 735 - 736.
[Full Text] [PDF]


Home page
J Am Coll CardiolHome page
A. E. Weyman
The Year in Echocardiography
J. Am. Coll. Cardiol., March 20, 2007; 49(11): 1212 - 1219.
[Full Text] [PDF]