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Right ventricular remodeling determines tricuspid valve geometry and the severity of functional tricuspid regurgitation: a real-time 3-dimensional echocardiography study.

Song JM, Jang MK, Kim YJ, Kim DH, Kang DH, Song JK - Korean Circ J (2010)

Bottom Line: Leaflet tenting angles were mainly determined by septal-lateral RV inlet dimension.Functional TR severity is determined by septal-lateral annulus and RV dilation, and tenting of septal and anterior leaflets.TV leaflet tenting is mainly determined by septal-lateral RV inlet dilation, and tricuspid annulus dilation is closely linked with inlet RV dilation.

View Article: PubMed Central - PubMed

Affiliation: Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

ABSTRACT

Background and objectives: Right ventricle (RV) remodeling can determine tricuspid valve (TV) geometry and the severity of functional tricuspid regurgitation (TR).

Subjects and methods: In 53 patients with various degrees of functional TR and in sinus rhythm, RV and TV geometries were analyzed using real-time 3-dimensional echocardiography, including tenting angles of 3 leaflets, septal-lateral and antero-posterior tricuspid annulus diameters and inlet RV dimensions, mid-RV septal-lateral dimension, and the distance between annulus and apex. A mid-systole frame when the TV tenting is smallest was selected for the analysis. RV end-diastolic and end-systolic volumes were measured. The severity of functional TR was determined by distal jet area.

Results: TR distal jet area was mainly determined by septal-lateral annulus diameter (p<0.001) RV inlet dimension (p=0.015), RV end-systolic volume (p=0.010), septal (p=0.019), and anterior leaflet tenting angles (p=0.045) by multiple stepwise linear regression analysis. Leaflet tenting angles were mainly determined by septal-lateral RV inlet dimension. Septal-lateral annulus diameter was determined by septal-lateral RV inlet dimension (p<0.001) and mid RV dimension (p=0.033), whereas antero-posterior annulus diameter was determined by antero-posterior RV inlet dimension (p<0.001).

Conclusion: Functional TR severity is determined by septal-lateral annulus and RV dilation, and tenting of septal and anterior leaflets. TV leaflet tenting is mainly determined by septal-lateral RV inlet dilation, and tricuspid annulus dilation is closely linked with inlet RV dilation.

No MeSH data available.


Related in: MedlinePlus

Correlations between septal-lateral right ventricular (RV) inlet dimension and tenting angles of the 3 leaflets.
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Figure 4: Correlations between septal-lateral right ventricular (RV) inlet dimension and tenting angles of the 3 leaflets.

Mentions: Among RV geometric factors, septal-lateral RV inlet dimension was the only determinant of Aα (Table 3). Septal-lateral RV inlet dimension was also the only determinant of Pα (Table 4). Sα was determined by septal-lateral RV inlet dimension and distance between TV annulus and RV apex (Table 5, Fig. 4). Septal-lateral annulus diameter was determined by septal-lateral RV inlet dimension and mid RV dimension (Table 6), whereas antero-posterior annulus diameter was determined by antero-posterior RV inlet dimension (Table 7, Fig. 5).


Right ventricular remodeling determines tricuspid valve geometry and the severity of functional tricuspid regurgitation: a real-time 3-dimensional echocardiography study.

Song JM, Jang MK, Kim YJ, Kim DH, Kang DH, Song JK - Korean Circ J (2010)

Correlations between septal-lateral right ventricular (RV) inlet dimension and tenting angles of the 3 leaflets.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2957637&req=5

Figure 4: Correlations between septal-lateral right ventricular (RV) inlet dimension and tenting angles of the 3 leaflets.
Mentions: Among RV geometric factors, septal-lateral RV inlet dimension was the only determinant of Aα (Table 3). Septal-lateral RV inlet dimension was also the only determinant of Pα (Table 4). Sα was determined by septal-lateral RV inlet dimension and distance between TV annulus and RV apex (Table 5, Fig. 4). Septal-lateral annulus diameter was determined by septal-lateral RV inlet dimension and mid RV dimension (Table 6), whereas antero-posterior annulus diameter was determined by antero-posterior RV inlet dimension (Table 7, Fig. 5).

Bottom Line: Leaflet tenting angles were mainly determined by septal-lateral RV inlet dimension.Functional TR severity is determined by septal-lateral annulus and RV dilation, and tenting of septal and anterior leaflets.TV leaflet tenting is mainly determined by septal-lateral RV inlet dilation, and tricuspid annulus dilation is closely linked with inlet RV dilation.

View Article: PubMed Central - PubMed

Affiliation: Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

ABSTRACT

Background and objectives: Right ventricle (RV) remodeling can determine tricuspid valve (TV) geometry and the severity of functional tricuspid regurgitation (TR).

Subjects and methods: In 53 patients with various degrees of functional TR and in sinus rhythm, RV and TV geometries were analyzed using real-time 3-dimensional echocardiography, including tenting angles of 3 leaflets, septal-lateral and antero-posterior tricuspid annulus diameters and inlet RV dimensions, mid-RV septal-lateral dimension, and the distance between annulus and apex. A mid-systole frame when the TV tenting is smallest was selected for the analysis. RV end-diastolic and end-systolic volumes were measured. The severity of functional TR was determined by distal jet area.

Results: TR distal jet area was mainly determined by septal-lateral annulus diameter (p<0.001) RV inlet dimension (p=0.015), RV end-systolic volume (p=0.010), septal (p=0.019), and anterior leaflet tenting angles (p=0.045) by multiple stepwise linear regression analysis. Leaflet tenting angles were mainly determined by septal-lateral RV inlet dimension. Septal-lateral annulus diameter was determined by septal-lateral RV inlet dimension (p<0.001) and mid RV dimension (p=0.033), whereas antero-posterior annulus diameter was determined by antero-posterior RV inlet dimension (p<0.001).

Conclusion: Functional TR severity is determined by septal-lateral annulus and RV dilation, and tenting of septal and anterior leaflets. TV leaflet tenting is mainly determined by septal-lateral RV inlet dilation, and tricuspid annulus dilation is closely linked with inlet RV dilation.

No MeSH data available.


Related in: MedlinePlus