Functional tricuspid regurgitation: An underestimated issue

Pulsed-wave Doppler interrogation of the hepatic veins (HVs) provides a window to right heart hemodynamics and function. Various pathologies that involve the right heart are manifested on the HV Doppler depending on the location and severity of the involvement and its hemodynamic consequences. Pulmonary hypertension (PHTN), a common finding on echocardiographic studies, imparts changes on the HV Doppler that are important to recognize. In this article, we provide a review of the main abnormalities that are encountered on the HV Doppler in patients with PHTN.

show abstract

“…Secondary TR is relatively common is patients with PHTN . When severe TR is present, it often dominates the Doppler findings in the HVs .…”

Section: Discussionmentioning

confidence: 99%

Spectral Doppler of the Hepatic Veins in Pulmonary Hypertension

et al. 2014

View full text Add to dashboard Cite

show abstract

“…Moderate-severe degrees of TR are best treated with bands or rings (2,6,7,21), with suture annuloplasty primarily reserved for mild-moderate cases (11,12). Three types of devices have been devised and implemented throughout the years, including standard rigid rings, flexible bands and 3D rigid rings (8).…”

Section: Publication Biasmentioning

confidence: 99%

“…Tricuspid regurgitation (TR) involves enlargement of the valve annulus and tethering of the leaflets, as a consequence of dilatation and/or dysfunction of the right sided heart chambers (1,2). Although mild TR is usually insignificant, moderate-severe TR is an independent risk factor for progressive heart failure and increased mortality (3)(4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

Flexible band versus rigid ring annuloplasty for tricuspid regurgitation: a systematic review and meta-analysis

Wang¹,

Phan²,

Tian³

et al. 2017

Ann. Cardiothorac. Surg.

View full text Add to dashboard Cite

Background: Up to 20% of patients have pre-discharge residual moderate to severe tricuspid regurgitation (TR) after tricuspid repair. Reoperations for recurrent TR carry high mortality rates, which emphasizes the importance of identifying the optimal technique for the surgical management of TR. The present study is a systematic review and meta-analysis that aims to compare short and long term survival and freedom from TR of flexible band ring versus rigid ring for annuloplasty of TR. Methods:We conducted a systematic review and meta-analysis of comparative studies to evaluate these procedures. A systematic search of the literature was performed from six electronic databases. Pooled metaanalysis was conducted using odds ratio (OR) and weighted mean difference (WMD).Results: The rates of in-hospital mortality were not different between the two groups, with cumulative rates Compared to flexible band, rates of TR are stable after rigid ring annuloplasty and long term freedom from TR are superior for rigid ring devices. Large prospective randomized trials are required in order to validate these findings and assess for improvements in patient survival.

show abstract

“…3–6 These remodeling changes also cause tricuspid annular dilation that not only worsens tricuspid regurgitation, but also contributes to the development of right atrial (RA) enlargement. 7–9 …”

Section: | Introductionmentioning

confidence: 99%

Maximal systolic excursion of the tricuspid annulus is independent of right atrial size and function in chronic pulmonary hypertension

2017

View full text Add to dashboard Cite

Background Even though the tricuspid annulus (TA) is anatomically and functionally related to right atrioventricular dependence and tricuspid annular plane systolic excursion (TAPSE) is a well-known measure of right ventricular (RV) systolic function, there is paucity of data regarding the potential impact that right atrial (RA) size and function have on TAPSE. Hence, we sought to determine whether RA volumetric and longitudinal measures affect TAPSE in patients with chronic pulmonary hypertension (cPH). Methods In this retrospective study, echocardiographic data from 110 patients were reviewed and the studied population was divided into Group I consisting of 50 patients (50±11 years) without PH and Group II that included 60 patients (55±14 years) with cPH. Results Even though RA areas, RA fractional area change, and maximal long-axis length measurements were abnormal in cPH patients, TA tissue Doppler imaging systolic velocity and RV fractional area change were the only useful variables in identifying patients with abnormal TAPSE (P<.0001 and P=.018, respectively). Additionally, TAPSE was independent of all RA measures, left ventricular ejection fraction, and age (P>.05). Conclusions Based on these results, TAPSE does not appear to be influenced by either RA size or function. Additional studies using strain echocardiography to interrogate RA mechanics might now be very useful to advance our understanding of TA motion in cPH patients given recent data showing that RA function accounts for a significantly greater proportion of total right heart function in patients with cPH than in normal subjects.

show abstract

Functional tricuspid regurgitation: An underestimated issue

Cited by 47 publications

References 43 publications

Spectral Doppler of the Hepatic Veins in Pulmonary Hypertension

Spectral Doppler of the Hepatic Veins in Pulmonary Hypertension

Flexible band versus rigid ring annuloplasty for tricuspid regurgitation: a systematic review and meta-analysis

Maximal systolic excursion of the tricuspid annulus is independent of right atrial size and function in chronic pulmonary hypertension

Contact Info

Product

Resources

About