Key result
Moderate-to-severe functional TR linked to ~84% greater diastolic RV volume on contrast CT.
Why the study?
It was uncertain whether morphological evaluation of functional tricuspid regurgitation could be performed using contrast-enhanced computed tomography.
Does contrast-enhanced CT accurately assess morphological changes of the tricuspid valve complex in patients with functional tricuspid regurgitation?
Cross-Sectional (n=50)
Open-label
No
Does contrast-enhanced CT accurately assess morphological changes of the tricuspid valve complex in patients with functional tricuspid regurgitation?
Contrast-enhanced CT can provide detailed morphological assessment of functional tricuspid regurgitation, with parameters like right ventricular volume and tricuspid annulus area correlating well with echocardiographic severity.
Answers are grounded in this paper and cite their sources.
CT parameters may correlate with TR severity on echo; leaves open whether contrast-enhanced CT can evaluate FTR morphology in practice.
BACKGROUND: Whether it is possible to perform morphological evaluation of functional tricuspid regurgitation (FTR) on contrast-enhanced computed tomography (CT) was examined by evaluating the relationships between the parameters measured on contrast-enhanced CT and TR severity on transthoracic echocardiography. METHODS: Fifty patients underwent contrast-enhanced CT. Tricuspid annulus area (TAA), tricuspid annulus circumference (TAC), right ventricular volume (RVV), and the distances between the tips and bases of the papillary muscles were measured on contrast-enhanced CT in diastole and systole. The 50 cases were divided into 34 in the TR ≤ mild group (no TR: 3 cases, trivial TR: 24 cases, mild TR: 7 cases), and 16 in the TR ≥ moderate group (moderate TR: 8 cases, severe TR: 8 cases) using the TR grade measured by transthoracic echocardiography, and then differences between the groups were examined. RESULTS: Significant differences were found in TAA, TAC, and RVV (p < 0.01) and the distances between the tips of the anterior and posterior papillary muscles (p < 0.05) in both diastole and systole. Since the septal papillary muscle could not be identified in 18 cases (36.0%), only the distance between the anterior and posterior papillary muscles was measurable in all cases. On receiver-operating characteristic (ROC) curve analysis, the areas under the ROC curves (AUCs) of TAA, TAC, and RVV were all > 0.7, and the maximum AUC was 0.925 for dRVV. CONCLUSIONS: TAA, TAC, RVV, and the distance between the tips of the anterior and posterior papillary muscles measured on contrast-enhanced CT were shown to be significantly increased in the TR ≥ moderate group. Detailed morphological assessment of FTR is possible by contrast-enhanced CT.
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Uchiyama et al. (2022) conducted a cross-sectional in Functional tricuspid regurgitation (n=50). Moderate or severe functional tricuspid regurgitation vs. Mild or less functional tricuspid regurgitation was evaluated on Diastolic right ventricular volume (dRVV) (AUC 0.925, p=<0.001). Moderate or severe functional tricuspid regurgitation was associated with significantly increased diastolic right ventricular volume (233.8 vs 127.4 mL, p<0.001) and tricuspid annulus area on contrast-enhanced CT, with dRVV yielding an AUC of 0.925.
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