scholarly journals Sources of Variability in Vena Contracta Area Measurement for Tricuspid Regurgitation Severity Grading: Comparison of Technical Settings and Vendors

2020 ◽  
Author(s):  
Yu Liu ◽  
Beiqi Chen ◽  
Yue Zhang ◽  
Wuxu Zuo ◽  
Quan Li ◽  
...  
Keyword(s):  
Tricuspid Regurgitation ◽  
Area Measurement ◽  
Vena Contracta ◽  
Severity Grading ◽  
Vena Contracta Area

Quantification of Tricuspid Regurgitation by Live Three-Dimensional Transthoracic Echocardiographic Measurements of Vena Contracta Area

2006 ◽  
Vol 23 (9) ◽  
pp. 793-800 ◽  
Author(s):  
Dasan E. Velayudhan ◽  
Todd M. Brown ◽  
Navin C. Nanda ◽  
Vinod Patel ◽  
Andrew P. Miller ◽  
...  
Keyword(s):  
Tricuspid Regurgitation ◽  
Three Dimensional ◽  
Vena Contracta ◽  
Vena Contracta Area

scholarly journals Prognostic Value of Echocardiographic Right Ventricular Function Parameters in the Presence of Severe Tricuspid Regurgitation

2021 ◽  
Vol 10 (11) ◽  
pp. 2266
Author(s):  
Matthias Schneider ◽  
Varius Dannenberg ◽  
Andreas König ◽  
Welf Geller ◽  
Thomas Binder ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Ventricular Function ◽  
Tricuspid Regurgitation ◽  
Right Ventricular Function ◽  
Prognostic Value ◽  
Large Scale ◽  
Systolic Function ◽  
Left Ventricular ◽  
Severe Tricuspid Regurgitation ◽  
Vena Contracta

Background: Presence of severe tricuspid regurgitation (TR) has a significant impact on assessment of right ventricular function (RVF) in transthoracic echocardiography (TTE). High trans-valvular pendulous volume leads to backward-unloading of the right ventricle. Consequently, established cut-offs for normal systolic performance may overestimate true systolic RVF. Methods: A retrospective analysis was performed entailing all patients who underwent TTE at our institution between 1 January 2013 and 31 December 2016. Only patients with normal left ventricular systolic function and with no other valvular lesion were included. All recorded loops were re-read by one experienced examiner. Patients without severe TR (defined as vena contracta width ≥7 mm) were excluded. All-cause 2-year mortality was chosen as the end-point. The prognostic value of several RVF parameters was tested. Results: The final cohort consisted of 220 patients, 88/220 (40%) were male. Median age was 69 years (IQR 52–79), all-cause two-year mortality was 29%, median TAPSE was 19 mm (15–22) and median FAC was 42% (30–52). In multivariate analysis, TAPSE with the cutoff 17 mm and FAC with the cutoff 35% revealed non-significant hazard ratios (HR) of 0.75 (95%CI 0.396–1.421, p = 0.38) and 0.845 (95%CI 0.383–1.867, p = 0.68), respectively. TAPSE with the cutoff 19 mm and visual eyeballing significantly predicted survival with HRs of 0.512 (95%CI 0.296–0.886, p = 0.017) and 1.631 (95%CI 1.101–2.416, p = 0.015), respectively. Conclusions: This large-scale all-comer study confirms that RVF is one of the main drivers of mortality in patients with severe isolated TR. However, the current cut-offs for established echocardiographic parameters did not predict survival. Further studies should investigate the prognostic value of higher thresholds for RVF parameters in these patients.

1051 Assessment of asymptomatic severe aortic regurgitation by doppler-derived echo indices: comparison with magnetic resonance quantification

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
Z Hlubocka ◽  
H Linkova ◽  
A Praveckova ◽  
A Polednova ◽  
G Dostalova ◽  
...  
Keyword(s):  
Volumetric Method ◽  
Flow Reversal ◽  
Descending Aorta ◽  
Vena Contracta ◽  
Severe Aortic Regurgitation ◽  
Diastolic Flow ◽  
Asymptomatic Patients ◽  
Doppler Indices ◽  
And Function ◽  
Vena Contracta Area

Abstract Funding Acknowledgements This study was supported by Ministry of Health of the Czech Republic 17-28265A Introduction Management of asymptomatic patients with chronic severe aortic regurgitation (AR) is challenging. Reliable quantification of the AR severity is essential. Transthoracic echocardiography (TTE) is a primary imaging modality. Grading of AR severity is achieved by an integrative approach. Cardiovascular magnetic resonance (CMR) can directly quantify AR severity by measuring regurgitation volume (RV) and regurgitation fraction (RF). Purpose There are few data on direct comparison between TTE and CMR for quantification of AR. Our study aimed to compare quantitative and indirect echo-Doppler indices to quantitative MRI derived parameters in asymptomatic patients with severe chronic AR. Methods In a prospective three-centre study, we evaluated patients with moderate to severe (3+) and severe (4+) chronic AR using TTE and CMR. All patients were asymptomatic, without indication for surgical treatment. The severity of AR was graded using TTE multiparametric approach. A 2-D and 3-D TTE were performed with an assessment of left ventricle size and function, valve morphology, Doppler parameters of AR including vena contracta width, diastolic flow reversal velocity in descending aorta, RV, RF using volumetric method, 3D-vena contracta area (3D-VCA). The CMR quantified left ventricle volumes and function, RF and RV using the phase-contrast velocity mapping. All imaging studies were analysed in CoreLab. Results A total of 104 patients were enrolled during 2015-2018. Mean patient age was 44 ± 13 years, 89 patients (86%) were males and 83 patients (81%) had a bicuspid or unicuspid aortic valve. Using the TTE severe (4+) AR was present in 48 (46%) and moderate to severe (3+) AR in 56 (54%) individuals. Concordant grading of AR severity with both techniques was observed in 77 (74%) patients. An integrative TTE approach showed a trend to underestimate AR severity. The best correlation between echo-Doppler indices and CMR measured RV and RF was found in two parameters: diastolic flow reversal velocity in descending aorta ( Rs = 0,62, p < 0,0001 for RV, Rs = 0,50, p < 0,0001 for RF) and 3D-VCA (Rs = 0,48 for RV, p < 0,0001 , Rs = 0,38 for RF, p < 0,0001). On the contrary vena contracta width showed poor correlation with CMR (Rs = 0,18, p = 0,07 for RV and Rs = 0,11, p = 0,29 for RF). Correlation between quantitative parameters of AR assessed by TTE volumetric method and CMR technique was modest (Rs = 0,40 for RF and Rs = 0,50 for RV, p < 0,0001), 95% confidence intervals were wide. Good correlation between TTE and CMR were found for LV dimensions, volumes and ejection fraction. Conclusion Out of indirect Doppler-echo indices of AR severity, diastolic flow reversal velocity in descending aorta and 3D-vena contracta area showed the best correlation with MRI derived RF and RV in patients with chronic severe AR. Quantitative parameters of AR (RF and RV) assessed by echo volumetric method had an only modest correlation to RF and RV measured using CMR.

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