Abstract 5780: Comparison of Right Ventricular Remodeling with the Use of a Novel Real Time Three Dimensional Echocardiographic Geometrical Model of the Tricuspid Valve
Introduction: Using a novel Real Time Three-dimensional (RT3D) echocardiographic model, we examined the relationship between right ventricular (RV) remodeling and the tricuspid valve.
Methods: Four groups were included: 50 patients with pulmonary hypertension (PAH) (age 42.3 ± 15.6 years), 50 patients with pulmonary hypertension, due to left heart disease (LHD) (age 48.9 ± 19.4 years), 30 patients with thromboembolic pulmonary hypertension (CTEPH) (age 36 ± 6.7 years) and 20 healthy subjects (H) (age 42 ± 8.9 years) were examined with RT3D. Views were obtained, with Vivid 7 (GE). The geometrical excursion of the tricuspid leaflets was assessed with the calculation of the leaflets angulation towards the tricuspid annulus in end-diastole and end-systole (Echopac) (Angles: 𝛉s-d: end-diastolic septal 𝛉p-d; end-diastolic posterior, 𝛉a-d: end-diastolic anterior, 𝛉s-s:end-systolic septal, 𝛉p-s: end-systolic posterior, 𝛉a-s: end-systolic anterior). End-diastolic (EDV) and end-systolic (ESV) volumes as well as RV ejection fraction (RV-EF) were measured with the method of disk summation. P<0.05 was significant
Results: Mean values are demonstrated below. The angulation of septal leaflet had preserved mobility in PAH patients, while anterior and posterior angles were decreased. LHD patients, had normal RV volumes, but the angle of the septal leaflet was decreased, when compared to the other leaflets, possible due to hypokinesis of the interventricular septum. CTEPH patients had the most decreased angulation of all leaflets possibly due to pressure loading right ventricular pattern. In PAH patients, there was correlation between the angulation of anterior and posterior leaflets and RV-EF(r=0.65, p<0.01 and r=0.73, p<0.01 respectively) which explains the anteroposterior dilatation.
Conclusion: RV remodeling is different as demonstrated with RT3D and that includes the shape and mobility of the tricuspid valve.