Diagnostic value of vena contracta area measurement for grading tricuspid regurgitation severity under different etiologies:a three-dimensional echocardiography study
10.3969/j.issn.1672-8467.2024.04.005
- VernacularTitle:直接描记缩流颈面积在不同病因下三尖瓣反流定量中的诊断效力:基于三维超声心动图的研究
- Author:
Bei-Qi CHEN
1
,
2
,
3
;
Yu LIU
;
Wu-Xu ZUO
;
Quan LI
;
Yuan-Feng WU
;
De-Hong KONG
;
Cui-Zhen PAN
;
Li-Li DONG
;
Xian-Hong SHU
Author Information
1. 复旦大学附属中山医院心超室 上海 200032
2. 上海市影像医学研究所 上海 200032
3. 上海市心血管病研究所 上海 200032
- Keywords:
tricuspid regurgitation(TR);
vena contracta area(VCA);
proximal isokinetic surface area(PISA);
effective regurgitant orifice area(EROA)
- From:
Fudan University Journal of Medical Sciences
2024;51(4):484-493,504
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the cut-off value of three dimensional(3D)vena contracta area(VCA)in diagnosing severe tricuspid regrugitation(TR)under different etiologies and its accuracy and practicality in clinical application.Methods From Mar 2019 to May 2021,ninety-two patients with confirmed TR underwent two dimensional(2D)and 3D transthoracic echocardiography.The correlation and consistency between 3D VCA 3D calculated based on the proximal isokinetic surface area(PISA)effective regurgitant orifice area(EROA)was calculated.Comprehensive 2D multi-parameter method was used as a reference method to calculate the cut-off value of the diagnosis of severe TR.Results A total of 85 patients were ultimately included.3D VCA and 3D PISA EROA had similar and acceptable correlations in both primary TR and secondary TR(primary TR:r=0.831,P<0.01;secondary TR:r=0.806,P<0.01).Bland-Altman analysis showed that 3D VCA overestimated TR compared with 3D PISA EROA(62%overestimated in the total patient population,51%overestimated in primary TR,and 74%overestimated in secondary TR).In secondary TR,the cut-off value of 3D VCA for diagnosing severe TR was 0.45 cm2(sensitivity 89%,specificity 82%);combining clinical symptoms,positive 2D PISA EROA results and 3D VCA results for severe TR,the chi-square value was higher than those only included clinical symptoms or incorporated clinical symptoms and positive 2D PISA EROA results(42.168 vs.26.059 and 16.759,P<0.01).Conclusion 3D VCA would overestimate TR,and had high and incremental diagnostic value for evaluating severe TR in secondary TR.
