Tricuspid valve geometry and right heart remodelling: insights into the mechanism of atrial functional tricuspid regurgitation
| Autor: | Kanako Izumi, Hitoshi Susawa, Yusuke Ueda, Kiho Itakura, Yasuki Kihara, Yu Harada, Yukiko Nakano, Takahiro Shiota, Takayuki Hidaka, Hiroto Utsunomiya |
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| Rok vydání: | 2020 |
| Předmět: |
Heart Ventricles
Echocardiography Three-Dimensional Geometry 030204 cardiovascular system & hematology 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Humans Medicine Radiology Nuclear Medicine and imaging Sinus rhythm Heart Atria Papillary muscle Tricuspid valve Atrium (architecture) Cardiac cycle Ventricular End-Systolic Volume business.industry Atrial fibrillation General Medicine medicine.disease Tricuspid Valve Insufficiency medicine.anatomical_structure Ventricle cardiovascular system Tricuspid Valve Cardiology and Cardiovascular Medicine business |
| Zdroj: | European Heart Journal - Cardiovascular Imaging. 21:1068-1078 |
| ISSN: | 2047-2412 2047-2404 |
| DOI: | 10.1093/ehjci/jeaa194 |
| Popis: | Aims We sought to investigate tricuspid valve (TV) geometry and right heart remodelling in atrial functional tricuspid regurgitation (AF-TR) as compared with ventricular functional TR with sinus rhythm (VF-TR). Methods and results Transoesophageal 3D echocardiography datasets of the TV and right ventricle were acquired in 51 symptomatic patients with severe TR (AF-TR, n = 23; VF-TR, n = 28). Three-dimensional right ventricular (RV) endocardial surfaces were reconstructed throughout the cardiac cycle and then postprocessed using semiautomated integration and segmentation software to calculate position of papillary muscle (PM) tips. Compared with VF-TR, AF-TR had more dilated and posteriorly displaced annulus and less leaflet tethering angles with more prominent right atrium and smaller RV end-systolic volume. On the XY (annular) plane, the centre of annulus was getting closer towards the anterior and posterior PM tips and was going away from the medial PM tip caused by prominent annular dilatation in AF-TR. On the Z-axis, the position of each PM tip in AF-TR was not so much displaced apically as that in VF-TR. Multiple linear regression analyses revealed that right atrial volume and right atrial/RV end-systolic volume ratio were determinants of annular area and orientation in AF-TR, respectively (both P Conclusion Right heart remodelling and its association with 3D TV geometry differ entirely between AF-TR and VF-TR, which may offer distinctive therapeutic implication. |
| Databáze: | OpenAIRE |
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