Three-dimensional transthoracic echocardiographic evaluation of tricuspid regurgitation severity using proximal isoveloc
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RESEARCH
Open Access
Three-dimensional transthoracic echocardiographic evaluation of tricuspid regurgitation severity using proximal isovelocity surface area: comparison with volumetric method Beiqi Chen1,2,3, Yu Liu1,2,3, Wuxu Zuo1,2,3, Quan Li1,2, Dehong Kong1,2,3, Cuizhen Pan1,2, Lili Dong1,2,3*, Xianhong Shu1,2,3* and Junbo Ge1,2,3
Abstract Background: The quantification of tricuspid regurgitation(TR) using three-dimensional(3D) proximal isovelocity surface area (PISA) derived effective regurgitant orifice area (EROA) is feasible in functional TR. The aim of our study was to explore the diagnostic accuracy and utility of 3D PISA EROA in a larger population of different etiologies. Methods: One hundred and seven patients with confirmed TR underwent 2D and 3D transthoracic echocardiography (TTE). 3D PISA EROA was calculated and EROA derived from 3D regurgitant volume (Rvol) was used as the reference. Results: 3D PISA EROA showed better correlation in primary TR than in functional TR(r = 0.897, P < 0.01). 3D PISA EROA differentiated severe TR with comparable accuracy in patients with primary and functional etiology (Z-value 16.506 vs 21.202), but with different cut-offs (0.49cm2 vs. 0.41 cm2). The chi-square value for incorporated clinical symptoms, positive echocardiographic results and 3D PISA EROA to grade severe TR was higher than only included clinical symptoms or incorporated clinical symptoms and positive echocardiographic results (chi-square value 137.233, P < 0.01). Conclusion: TR quantification using 3D PISA EROA is feasible and accurate under different etiologies. It has incremental diagnostic value for evaluating severe TR. Keywords: Three-dimensional echocardiography, Tricuspid regurgitation, Proximal isovelocity surface area, Effective regurgitant orifice area
* Correspondence: [email protected]; [email protected] 1 Department of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai, China Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this ar
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