Key result
Three-dimensional echocardiography parameters, particularly tricuspid annulus area, accurately differentiated moderate from severe functional tricuspid regurgitation (AUC 0.90).
Why the study?
Accurate sizing of the tricuspid valve annulus is critical for optimal timing of intervention, but 2D echocardiography has limitations compared to 3D imaging for comprehensive analysis.
Does 3D echocardiography improve the assessment of tricuspid annular geometry and differentiation of functional tricuspid regurgitation grades compared to 2D echocardiography in adult patients?
Cross-Sectional (n=155)
No
Does 3D echocardiography improve the assessment of tricuspid annular geometry and differentiation of functional tricuspid regurgitation grades compared to 2D echocardiography in adult patients?
Effect estimate: AUC 0.90 (95% CI 0.83-0.95)
p-value: p=<0.001
3D echocardiography provides larger and more accurate measurements of the tricuspid annulus than 2D echocardiography, offering reliable cut-off values to differentiate between grades of functional tricuspid regurgitation.
3D TA measurements may refine assessment across TR grades; hypothesis-generating for intervention timing.
BACKGROUND: Accurate sizing of the tricuspid valve annulus is essential for determining the optimal timing of tricuspid valve (TV) intervention. Two-dimensional (2D) echocardiography has limitations for comprehensive TV analysis. Three-dimensional (3D) imaging of the valve provides a better understanding of its spatial anatomy and enables more accurate measurements of TV structures. OBJECTIVES: The study aimed to analyze tricuspid annulus (TA) parameters in normal heart and in different grades of functional tricuspid regurgitation (TR); to compare TA measurements obtained by 2D and 3D echocardiography. METHODS: One hundred fifty-five patients (median age 65 years, 57% women) with normal TV and different functional TR grades underwent 2D and 3D transthoracic echocardiography. The severity of TR was estimated using multiparametric assessment according to the guidelines. Mid-systolic 3D TA parameters were calculated using TV dedicated software. The conventional 2D systolic TA measurements in a standard four-chamber view were performed. RESULTS: for women. When indexed to body surface area (BSA), there were no significant differences in the 3D parameters between genders. The 2D TA diameters were smaller than those measured in 3D. The ROC curve analysis identified that all 3D TA parameters can accurately differentiate between different functional TR grades. Additionally, the optimal cut-off values were identified for each TA parameter. CONCLUSIONS: Gender, body size, and age have an impact on the TA parameters in healthy subjects. 2D measurements are smaller than 3D parameters. The reference values for 3D metrics according to TR severity can help in identifying TA dilation and distinguishing between different functional TR grades.
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Bieliauskienė et al. (2023) conducted a cross-sectional in Functional tricuspid regurgitation (n=155). Three-dimensional echocardiography vs. Two-dimensional echocardiography was evaluated on Differentiation of moderate from severe functional tricuspid regurgitation using 3D tricuspid annulus area (AUC 0.90, 95% CI 0.83-0.95, p=<0.001). Three-dimensional echocardiography parameters, particularly tricuspid annulus area, accurately differentiated moderate from severe functional tricuspid regurgitation (AUC 0.90).
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