Key result
Tricuspid annulus dilatation is linked to RV and RA enlargement on multiphase CT.
Why the study?
Secondary functional tricuspid regurgitation management remains controversial, largely because its pathogenesis is poorly understood and measuring true tricuspid annulus dimensions remains challenging with current imaging techniques.
Does multiphase cardiac CT reveal modifications in tricuspid annulus morphometry and dynamics in patients with secondary functional tricuspid regurgitation?
Observational (n=72)
Does multiphase cardiac CT reveal modifications in tricuspid annulus morphometry and dynamics in patients with secondary functional tricuspid regurgitation?
Multiphase CT analysis demonstrates that tricuspid annulus dilatation is present in severe mitral myxomatous disease even without tricuspid dysfunction, challenging current cut-off recommendations for concomitant tricuspid annuloplasty.
CT links tricuspid annulus dilatation to right heart enlargement in mitral disease; hypothesis-generating and does not support changing annuloplasty thresholds.
Objectives: Secondary functional tricuspid regurgitation (FTR) management remains controversial mainly due to the lack of knowledge in its pathogenesis and the difficulties to measure the actual dimensions of tricuspid annulus (TA) with current imaging methods. Using a novel method based on multiphase cardiac computed tomography (CT) scan acquisition to accurately analyze the right atrioventricular junction size, we sought to explore modifications of TA morphometry and dynamics in secondary FTR. Methods: Echocardiographic and cardiac CT studies were obtained from 21 patients with severe mitral regurgitation (MR group) and 21 patients with dilated cardiomyopathy (DCMP group). Using an in-house software, a 3-dimensiontal (3D) semiautomated delineation of the TA perimeter was assessed. Modifications of diameters, 2-dimensional/3D areas and perimeters were analyzed through time. These 2 groups of patients were compared with 30 healthy subjects, considering the presence of a significant (≥2+) versus nonsignificant (<2+) FTR in each group. Conclusions: Based on multiphase CT image analyses, TA dilatation was directly related to RV and RA enlargement. Patients with severe mitral myxomatous disease and nondysfunctional tricuspid valve had yet dilated TA, which questioned the current cut-off recommendation for concomitant tricuspid annuloplasty in this specific population.
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Jouan et al. (2023) conducted an observational in Secondary functional tricuspid regurgitation (n=72). Multiphase cardiac computed tomography (CT) scan analysis vs. Healthy subjects was evaluated on Modifications of tricuspid annulus morphometry and dynamics (diameters, 2D/3D areas, and perimeters) (p== .002). Multiphase CT analysis demonstrated that tricuspid annulus dilatation was directly related to right ventricular and right atrial enlargement (P=0.002).
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