Three-dimensional echocardiography revealed that rheumatic tricuspid valve involvement is characterized by restricted mobility (85.3%), leaflet thickening (82.4%), and commissural fusion (50.0%).
Cohort (n=34)
No
Does three-dimensional echocardiography (3DE) accurately characterize valvular morphology and hemodynamics in patients with rheumatic tricuspid valve disease?
Three-dimensional echocardiography provides detailed morphological characterization of rheumatic tricuspid valve disease, particularly in identifying commissural fusion and quantifying valve area, which may aid in procedural planning.
Background: Rheumatic heart disease (RHD) remains a prevalent cause of valvular heart pathology worldwide, especially in younger populations of low- and middle-income countries. Tricuspid valve (TV) involvement in RHD is usually secondary to left-sided valvular lesions and is often underdiagnosed, since two-dimensional echocardiography (2DE) has limited ability to visualize the complex tricuspid anatomy. Compared with 2DE, three-dimensional echocardiography (3DE) provides an en face visualization of the tricuspid valve, enabling direct planimetric measurements and detailed commissural assessment, and offers advantages for evaluating complex valvular heart disease (VHD). Thus, this study aimed to assess baseline characteristics and valvular morphology in patients with rheumatic tricuspid valve disease using 3DE. Methods: A prospective cohort single-center study conducted between April 2022 and April 2023 included 34 patients with rheumatic TV involvement. Baseline demographics, morphological features, and hemodynamic parameters were assessed using transthoracic 3DE. Results: The mean age of included patients was 45.5 ± 9.1 years, and 88.2% were female. Most patients had associated left-sided valvular involvement (mitral or combined mitral and aortic). Commissural fusion (50%), leaflet thickening (82.4%), restricted mobility (85.3%), and coaptation loss (58.8%) were predominantly noted. The mean diastolic TV gradient was 3.9 ± 3.4 mmHg, planimetry area 3.3 ± 1.7 cm2, and estimated pulmonary artery systolic pressure 43.3 ± 19.5 mmHg. Mean right ventricular (RV) global longitudinal strain was –23.6 ± 6.1%. Conclusion: Rheumatic TV involvement is characterized by commissural fusion, leaflet thickening, and coaptation loss, highlighting the diagnostic value of 3DE in identifying morphological patterns that may guide intervention planning.
Abdelnabi et al. (Fri,) conducted a cohort in Rheumatic tricuspid valve disease (n=34). Three-dimensional echocardiography (3DE) was evaluated on Morphological and hemodynamic abnormalities of the tricuspid valve. Three-dimensional echocardiography revealed that rheumatic tricuspid valve involvement is characterized by restricted mobility (85.3%), leaflet thickening (82.4%), and commissural fusion (50.0%).