Abstract 14836: Dynamic Analysis of the Normal Tricuspid Annulus Using 3D Echocardiography
Background: Changes in the geometry of the normal tricuspid annulus (TA) throughout the cardiac cycle using transthoracic three-dimensional echocardiography (3DTTE) have not been extensively described. We sought to characterize TA dynamics in normal subjects as a basis for better understanding of TV pathology.
Methods: 98 subjects (45±15 years, (range 19-80 years), BSA 1.81±0.22m2, 44 men) with normal TV underwent 3DTTE full volume imaging of the TA and right ventricle (RV) (Philips, iE33 and GE Vivid E9) at 2 University Hospitals. Subjects had a normal 2DTTE, RV systolic pressure ≤35mmHg and RV ejection fraction=55±7% (TomTec). Measurements were made (QLAB 9.0, Philips and EchoPAC BT 12, GE) of the TA area, antero-posterior (AP) and septal-lateral (SL) TA dimensions at the onset of systole (closure of the TV), end-systole (prior to TV opening), mid-systole (mid-point between onset and end-systole), early-diastole (initial TV leaflet opening) and late-diastole (after atrial contraction).
Results: Mean TA area and dimensions varied throughout the cardiac cycle (Table), being the largest in late-diastole and smallest at the onset of systole. TA fractional area change was 38%. The TA AP dimension was larger than the SL dimension throughout the cardiac cycle (fig.A). Fractional changes in AP and SL dimensions were 23% and 18%, respectively. No significant differences were noted between genders (fig.B) or age groups.
Conclusions: Normal TA is a highly dynamic structure; this has important implications for its sizing. Customized software to characterize TA remodeling and dynamics throughout the entire cardiac cycle is needed for a better understanding of TV pathology.
- © 2013 by American Heart Association, Inc.