ASSESSMENT OF TRICUSPID REGURGITATION BY DOPPLER COLOR-FLOW IMAGING -ANGIOGRAPHIC CORRELATION

The correlation between data obtained by Doppler color flow imaging an d angiographic severity has been investigated in mitral and aortic reg urgitation. However, similar studies have not been performed for tricu spid regurgitation (TR). This study was performed to establish the cor relation between measurements of regurgitant jet area by Doppler color flow imaging and the angiographic severity of TR. Fifty-four patients with rheumatic heart disease who underwent right ventriculography and transthoracic Doppler color flow imaging were studied. The regurgitan t jet area was measured as the largest clearly definable flow disturba nce in apical four-chamber and right ventricle inflow views, and expre ssed in both views as the absolute jet area or as the ratio of maximal jet area to right atrial area. Correlation of all Doppler color flow measurements with angiographic grades of TR were comparable, absolute jet area in apical four-chamber view being closest at r = 0.80. A regu rgitant jet area in apical four-chamber view < 5 cm(2) predicted minim al or mild TR by angiography with a sensitivity of 78% and a specifici ty of 100%, whereas a regurgitant jet area > 10 cm(2) predicted severe TR with a sensitivity of 92% and a specificity of 91%. Values between 5 and 10 cm(2) predicted moderate TR with a sensitivity of 89% and a specificity of 89%. Sensitivity and specificity were not improved with use of the ratio of jet area to right atrial area or with use of righ t ventricle inflow view. Thus, Doppler color flow jet measurements cor relate closely with angiographic results in the evaluation of TR. Regu rgitant jet area in apical four-chamber view shows the highest sensiti vity and specificity to predict the angiographic grade of TR.