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- Title
A new and simple method for clarifying the severity of tricuspid regurgitation.
- Authors
Izgi, Ibrahim Akin; Acar, Emrah; Kilicgedik, Alev; Guler, Ahmet; Cakmak, Ender Ozgun; Demirel, Muhittin; Izci, Servet; Yilmaz, Mehmet Fatih; Inanir, Mehmet; Kirma, Cevat
- Abstract
Background No gold standard exists for grading tricuspid regurgitation ( TR) severity. We developed a simple parameter, the right ventricular ( RV) early inflow-outflow ( RVEIO) index, using the early diastolic filling velocity and RV outflow velocity integrated over the systolic ejection period. We hypothesized that this index would help identify severe TR in clinical practice. Methods We obtained data from routine transthoracic echocardiograms. All records reporting moderate (n=395) or severe (n=395) TR were reanalyzed to measure vena contracta ( VC) width, TR jet area, effective regurgitant orifice ( EROA) derived with the proximal isovelocity surface area method, RVEIO index, and right-sided chamber volumes. Results Significant linear trends were demonstrated for right atrial volume index, end-diastolic volume index, E-wave velocity, RV velocity time integral, TR jet area, VC width, and EROA with increasing TR severity. Independent predictors of severe RT included RVEIO index ≥ 10, VC width ≥ 0.7 cm, TR jet area>10 cm2, and EROA ≥ 0.4 cm2. Conclusion RVEIO index is a useful, simple, accurate, and independent predictor of severe TR that adds incrementally to traditional methods of quantifying TR severity. Accurate quantification and classification of TR severity is critical for clinical decision-making and management; therefore, the incorporation of RVEIO index into the integrative approach to grading TR severity should be considered.
- Subjects
ANALYSIS of variance; CHI-squared test; CONFIDENCE intervals; CORONARY circulation; DOPPLER echocardiography; RIGHT heart ventricle; HEART valve diseases; T-test (Statistics); TRICUSPID valve; LOGISTIC regression analysis; SEVERITY of illness index; RECEIVER operating characteristic curves; DATA analysis software; DESCRIPTIVE statistics; ODDS ratio; MANN Whitney U Test; CLASSIFICATION; PHYSIOLOGY
- Publication
Echocardiography, 2017, Vol 34, Issue 3, p328
- ISSN
0742-2822
- Publication type
Article
- DOI
10.1111/echo.13458