Three-dimensional geometry of the tricuspid annulus in healthy subjects and in patients with functional tricuspid regurgitation - A real-time, 3-dimensional echocardiographic study
Three-dimensional geometry of the tricuspid annulus in healthy subjects and in patients with functional tricuspid regurgitation - A real-time, 3-dimensional echocardiographic study
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DOI：
10.1161/circulationaha.105.000257
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发表时间：
2006-07-04
期刊：
影响因子：
37.8
通讯作者：
Shiota, Takahiro
中科院分区：
文献类型：
--
作者：
Fukuda, Shota;Saracino, Giuseppe;Shiota, Takahiro
背景-目前用于三尖瓣环成形术的大多数环是在一个平面上形成的，而实际的三尖瓣环（TA）可能具有非平面或三维（3D）结构。因此，本研究的目的是研究健康受试者和功能性三尖瓣反流（TR）患者TA的三维几何形状。方法与结果：本研究包括15名健康受试者和16名功能性TR患者，并进行实时3D超声心动图检查。利用我们定制的软件，沿着TA以45度的间隔旋转平面确定8个点。TA在一个心动周期中被追踪到。测量连接两点的对角线之间的距离。高度定义为所有8个点与平面的距离，通过最小二乘回归分析确定。TR患者TA最大面积(7.5 +/- 2.1 vs 5.6 +/- 1.0 cm（2)/m(2)）和最小面积(5.7 +/- 1.3 vs 3.9 +/- 0.8 cm（2)/m(2)）均大于健康者（P均< 0.01）。健康受试者TA呈非平面形状，收缩均匀。从右心房向心尖方向，后间隔部分最低，前间隔部分最高。在功能性TR患者中，TA在间隔向外侧方向扩张，形成比健康受试者更圆的形状。在TR患者中观察到类似的3D模式，但比健康受试者更平面。结论-实时三维超声心动图显示TA复杂的三维结构，与“鞍形”二尖瓣环不同，提示TR环成形术与二尖瓣反流成形术不同。
Background - Most rings currently used for tricuspid valve annuloplasty are formed in a single plane, whereas the actual tricuspid annulus (TA) may have a nonplanar or 3-dimensional (3D) structure. The purpose of this study was therefore to investigate the 3D geometry of the TA in healthy subjects and in patients with functional tricuspid regurgitation (TR).Methods and Results - This study consisted of 15 healthy subjects and 16 patients with functional TR who had real- time 3D echocardiography. With our customized software, 8 points along the TA were determined with the rotated plane around the axis at 45 degrees intervals. The TA was traced during a cardiac cycle. The distance between diagonals connecting 2 points was measured. The height was defined as the distance from the plane determined by least- squares regression analysis at all 8 points. Both the maximum (7.5 +/- 2.1 versus 5.6 +/- 1.0 cm(2)/m(2)) and minimum (5.7 +/- 1.3 versus 3.9 +/- 0.8 cm(2)/m(2)) TA areas in patients with TR were larger than those in healthy subjects (both P < 0.01). Healthy subjects had a nonplanar-shaped TA with homogeneous contraction. The posteroseptal portion was the lowest toward the apex from the right atrium, and the anteroseptal portion was the highest. In patients with functional TR, the TA was dilated in the septal to lateral direction, resulting in a more circular shape than in healthy subjects. A similar 3D pattern was observed in patients with TR, but it was more planar than that in healthy subjects.Conclusions - Real-time 3D echocardiography showed a complicated 3D structure of the TA, which appeared to be different from the "saddle- shaped" mitral annulus, suggesting an annuloplasty for TR different from that for mitral regurgitation.