Key result
Rheumatic heart disease is linked to a ~20% incidence of organic tricuspid valve disease.
Why the study?
Tricuspid valve disease in rheumatic heart disease is often overlooked and under-recognized despite its clinical significance and impact on outcomes.
What is the incidence of tricuspid valve disease assessed by echocardiography in patients with rheumatic heart disease?
Observational (n=278)
What is the incidence of tricuspid valve disease assessed by echocardiography in patients with rheumatic heart disease?
The incidence of organic tricuspid valve disease in patients with rheumatic heart disease is significant (20.1%), highlighting the need for routine echocardiographic assessment of the tricuspid valve in this population.
May warrant tricuspid assessment in RHD evaluation; extends prevalence data but leaves open clinical implications.
Right-sided valve abnormalities are less common than their leftsided counterparts.Unfortunately, tricuspid valve stenosis is easily missed at clinical examination except in advanced cases when a high degree of clinical suspicion exists.Undetected and thus uncorrected tricuspid valve stenosis may lead to postoperative low cardiac output despite successful relief of left sided valve disease and carries a high mortality and morbidity.However, in most patients, it is not possible to visualise all three tricuspid valve leaflets simultaneously with 2DE.Furthermore, whilst organic rheumatic involvement of the tricuspid valve is not uncommon, it receives less attention than left-sided heart valves.Our aim was to study the incidence of tricuspid valve disease (TVD) in patients with rheumatic heart disease (RHD).Methods: We prospectively studied 278 patients with RHD from August 2011 to June 2012.Tricuspid valve was examined echocardiographically for Tricuspid Stenosis (TS) & Tricuspid Regurgitation (TR).The severity of TS & TR was graded according to ASE guidelines.Results: Among 278 patients with RHD, 56 patients (20.1%) had organic Tricuspid valve disease; patients with Tricuspid stenosis and Tricuspid regurgitation were 15 (5.4%) and with organic Tricuspid regurgitation were 34 (12.2%).The patients with normal tricuspid valve functional Tricuspid regurgitation were 54%.From total number of patients with organic Tricuspid regurgitation, 4 patients (1.4%) had mild Tricuspid regurgitation, 18 Patients (6.4%) had moderate Tricuspid regurgitation & 12 patients (4.3%) had severe Tricuspid regurgitation.From total number of patients with TS, 9 patients (3.2%) had mild Tricuspid stenosis & 6 patients (2.1%) had severe Tricuspid stenosis.Conclusion: The incidence of Tricuspid valve disease in RHD is higher in our studies compared to previous literatures.RTVD is not uncommon among patients with rheumatic heart disease, but attracts less attention and might, therefore, be overlooked.Echocardiographic assessment of tricuspid valve is must particularly in all RHD patients for further management of treatment.
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A 2012 study conducted an observational in Rheumatic heart disease (n=278). Rheumatic heart disease was evaluated on Incidence of organic tricuspid valve disease. Among patients with rheumatic heart disease, the incidence of organic tricuspid valve disease was 20.1%, demonstrating that right-sided valve involvement is not uncommon.
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