Normal Reference Values and Reproducibility of Tricuspid Annulus Dimensions Using Cardiovascular Magnetic Resonance
Normal Reference Values and Reproducibility of Tricuspid Annulus Dimensions Using Cardiovascular Magnetic Resonance
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DOI：
10.1016/j.amjcard.2019.05.019
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发表时间：
2019-08-15
影响因子：
2.8
通讯作者：
Shah, Dipan J.
中科院分区：
文献类型：
--
作者：
Zhan, Yang;Debs, Dany;Shah, Dipan J.
三尖瓣环（TA）扩张是功能性三尖瓣反流的关键过程，但使用心血管磁共振尚未建立正常TA尺寸。我们测量了66名健康志愿者的TA直径，年龄38 ± 11岁，在心动周期的3个不同阶段（收缩末期，早期心室舒张末期和末期心室舒张末期）和2个常规获得的心血管磁共振成像平面（4腔[4C]和右心室流入流出[RVIO]）。3名阅片人独立测量每个值，1名阅片人间隔1个月重复测量。正常上限（ULN）计算为高于平均值1.96个标准差。我们使用组内相关系数（ICC）和Bland-Altman分析评估观察者间和观察者内的可靠性。我们发现，在4C视图中，TA直径在早期栓塞期间最大，ULN为43 mm（22 mm/m2）。男性TA绝对直径（36 mm，95% CI 27 - 44 mm）大于女性（30 mm，95% CI 23 - 37 mm），但在体表面积指数化后并非如此（均为18 mm/m2）。在RVIO视图中，最大TA直径发生在早期栓塞期间，ULN值为46 mm（27 mm/m（2））。从这个角度来看，女性的TA指数大于男性（21 mm/m2 vs 17 mm/m2）。所有心动时相的测量重现性均极佳，评估者间ICC介于0.90至0.96之间，评估者内ICC介于0.89至0.96之间。总之，我们在常规采集的4C和RVIO视图中提供了关于TA尺寸的规范性数据，这些值大于超声心动图测量的瓣环扩张的当前阈值。RVIO视图中TA直径的性别差异可能是考虑未来三尖瓣器械的重要发现。(C)2019爱思唯尔公司All rights reserved.
Tricuspid annular (TA) dilation is a key process in functional tricuspid regurgitation, but normal TA dimensions using cardiovascular magnetic resonance have not been established. We measured TA diameters in 66 healthy volunteers, aged 38 +/- 11 years, during 3 different phases of the cardiac cycle (end-systole, early diastole, and end-diastole) and in 2 routinely acquired cardiovascular magnetic resonance imaging planes (4-chamber [4C] and right ventricular inflow-outflow [RVIO]). Three readers independently measured each value and 1 reader repeated measurements 1 month apart. The upper limit of normal (ULN) was calculated as 1.96 standard deviations above the mean. We assessed inter- and intraobserver reliability using the intraclass correlation coefficient (ICC) and Bland-Altman analysis. We found the TA diameter largest during early diastole in the 4C view with an ULN of 43 mm (22 mm/m(2)). Men had larger absolute TA diameters (36 mm, 95% CI 27 to 44 mm) than women (30 mm, 95% CI 23 to 37 mm) but not after indexing for body surface area (both 18 mm/m(2)). In the RVIO view, the largest TA diameter occurred during early diastole with a ULN value of 46 mm (27 mm/m(2)). In this view, females had a larger indexed TA than men (21 mm/m 2 vs 17 mm/m(2)). Reproducibility of measurements was excellent in all cardiac phases with an inter-rater ICC between 0.90 to 0.96 and an intrarater ICC 0.89 to 0.96. In conclusion, we have provided normative data regarding TA dimensions in routinely acquired 4C and RVIO views, and these values are larger than the current thresholds of annular dilation measured by echocardiography. Gender differences with the TA diameter in the RVIO view may be an important finding with consideration of future tricuspid devices. (C) 2019 Elsevier Inc. All rights reserved.