Diagnosis of tricuspid regurgitation by contrast echocardiography.

Meltzer, Richard S.; Hoogenhuyze, Diederik Van; Serruys, Patrick W.; Haalebos, M.M.P.; Hugenholtz, Paul G.; Roelandt, Jos R.T.C.

doi:10.1161/01.cir.63.5.1093

Cited by 90 publications

(14 citation statements)

References 12 publications

(1 reference statement)

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“…In these same autopsied hearts, the mean mitral valve annular circumference in the fresh state was 1 1.4 + 0.7 cm and in the fixed state, 10 lus.20 The two-dimensional echocardiographic and the autopsy measurements in the present study confirm this observation.…”

Section: Autopsy Studysupporting

confidence: 75%

The tricuspid valve annulus: study of size and motion in normal subjects and in patients with tricuspid regurgitation.

Tei¹,

Pilgrim²,

Shah³

et al. 1982

Circulation

229

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SUMMARY The tricuspid valve leaflets and their annular attachments were recorded by two-dimensional echocardiography from a view of the right ventricular inflow tract obtained by placing the transducer at an intermediate position between the left ventricular apex and the left lower sternal border. The transducer was rotated, and recordings were made at 300 rotational intervals around the circumference of the tricuspid valve annulus. The cyclical pattern of variations in tricuspid annular size was studied with 12 measurements made during the cardiac cycle in five normal subjects. Annular areas and circumferences were measured. The overall motion pattern was-similar to that reported in normal mitral valve annular study. Subsequently, in 16 normal subjects and 18 patients with tricuspid regurgitation, the maximum and minimum tricuspid annular sizes and their percent reduction were measured. The mean maximum annular circumference and area were 11.9 ± 0.9 cm (mean ± SD) and 11.3 ± 1.8 cm2 in normal subjects. They were significantly greater in tricuspid regurgitation (14.0 ± 0.7 cm and 15.8 ± 1.8 cm2, respectively). The mean minimum annular sizes were much larger in tricuspid regurgitation (12.5 ± 0.6 cm and 13.0 ± 1.4 cm2) than in normal subjects (9.6 ± 0.9 cm, 7.6 ± 1.4 cm2). Thus, the percent reduction of annular circumference and area were significantly decreased in tricuspid regurgitation. For anatomic correlations, measurements of the tricuspid annular circumference were made at autopsy in 18 hearts without underlying valvular disease. The annular circumference was measured in the fresh and fixed states. The measurement in the fresh state was 13.5 ± 0.8 cm and in the fixed state was 12.0 ± 0.8 cm. The values measured in the fixed hearts were more similar to measurements obtained by echocardiography in a group of normal subjects.Thus, tricuspid annular reconstruction by the new two-dimensional echocardiographic method provides additional information about normal and abnormal size and function of the tricuspid valve annulus.THE MOST COMMON cause of tricuspid regurgitation (TR) is not intrinsic involvement of the valve itself, but dilatation of the tricuspid valve annulus.' The results of tricuspid annuloplasty for correction of significant tricuspid regurgitation have usually been successful.2-6 No technique is available to measure tricuspid annular size and assess annular function, and no reports have described the tricuspid annular size and motion in intact man. In a study using two-dimensional echocardiography from our laboratory, we described a method of reconstructing the mitral annulus using multiple apical planes obtained by 30°rotations of the transducer.7 In the present report, we used a similar method to reconstruct the tricuspid annulus using multiple echocardiographic planes obtained from another transducer location.In the present paper we describe a noninvasive method of evaluating the size of the tricuspid valve annulus and its variations during the cardiac cycle in

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Section: Autopsy Studysupporting

confidence: 75%

The tricuspid valve annulus: study of size and motion in normal subjects and in patients with tricuspid regurgitation.

Tei¹,

Pilgrim²,

Shah³

et al. 1982

Circulation

229

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“…This pattern is in agreement with previous reports (Gullace 1982;Meltzer et al, 1981;Savoia and Gullace, 1983). According to the above data, it seems that the IVC motion, and not the IP, is an expression of the hemodynamic events of the right atrium.…”

Section: Resultssupporting

confidence: 94%

“…But the overlap of values and low sensitivity and specificity preclude the reliability of this index (Meltzer et al, 1981). However, a decreased percentage of systolic pulsation was found in patients with pericardial effusion, and despite the difficulties encountered in identifying the v wave and measuring the correspondent dimension because of its remarkable reduction of wall motion, it was found to be a sensitive index for pericardial effusion more than for tricuspid regurgitation.…”

Section: Ivc Relation With Respiratory Events Cardiac Cycle Andrbytbmmentioning

confidence: 99%

Echocardiographic assessment of the inferior vena cava wall motion for studies of right heart dynamics and function

Gullace¹,

Savoia²

1984

Clinical Cardiology

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Summary: Using subcostal echocardiography, 97 patients with diseases involving the right side of the heart and 15 nonnal subjects were examined in order to study the inferior vena cava (lVC) wall motion. All cases had a diagnostic cardiac catheterization and routine echocardiogram. The jugular pulse (JP) was recorded in 35 random cases contemporary to the IVC and tricuspid valve (TV) tracings. The aim of the study was to evaluate the variations of the IVC diameters in different cardiopathies and in relation to the right atrial mean pressure and the time-relationship of the IVC wall motion related to the cardiac rhythm and cycle, respiratory events, and IP and TV waves. The a, b, v, and y waves were identified on the IVC tracings and related to the respective waves of the IP and the points of closure and opening of the TV. The IVC a and v waves were coincident with the TV closure and opening, and therefore, considered as moments of maximal presystolic and systolic filling of the IVC. The IP a wave inscribed before, Whereas the v wave did so after the same IVC waves, respectively. The IVC a wave was due to the atrial contraction and influenced by the cardiac rhythm. The emptying index (EI) was calculated from the diameters in a and b as a -b/a x %, whereas the collapsability index

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“…Two disorders result in retrograde flow from the right atrium into the inferior vena cava: tricuspid regurgitation [7,17], and atrial septa defect . Tricuspid regurgitation causes V-wave synchronous reflux into the inferior vena cava [7], which would be simultaneous with first lung visualization.…”

Section: False-positive "Tail" Signmentioning

confidence: 99%

Radionuclide diagnosis of infradiaphragmatic total anomalous pulmonary venous drainage

et al. 1985

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We hypothesized that infradiaphagmatic total anomalous pulmonary venous drainage (ITAPVD), because of its unique physiology, could be diagnosed with radionuclide angiography. Seven neonates with severe respiratory distress were injected intravenously with 3 mCi technetium-99m pertechnetate. In each of four neonates demonstrated to have ITAPVD by pulmonary angiography, nuclide recirculation through the right atrium occurred 3-6 s after initial passage. In addition, direct visualization of the anomalous common pulmonary trunk with nuclide as a "tail" below the diaphragm was obvious in the third infant studied. This prompted review of the first two infants with ITAPVD; in retrospect the anomalous trunk was also visualized with nuclide in both of these infants. All three were injected via the upper extremity. In the fourth ITAPVD infant, nuclide was injected via the lower extremity. In that infant, preferential streaming of the inferior vena caval flow and nuclide across the foramen ovale into the left heart led to simultaneous opacification of anomalous trunk and descending aorta, obscuring the "tail" sign.

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Diagnosis of tricuspid regurgitation by contrast echocardiography.

Cited by 90 publications

References 12 publications

The tricuspid valve annulus: study of size and motion in normal subjects and in patients with tricuspid regurgitation.

The tricuspid valve annulus: study of size and motion in normal subjects and in patients with tricuspid regurgitation.

Echocardiographic assessment of the inferior vena cava wall motion for studies of right heart dynamics and function

Radionuclide diagnosis of infradiaphragmatic total anomalous pulmonary venous drainage

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