Cm. Tribouilloy et al., Quantification of tricuspid regurgitation by measuring the width of the vena contracts with Doppler color flow imaging: A clinical study, J AM COL C, 36(2), 2000, pp. 472-478
Citations number
48
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
OBJECTIVE We sought to evaluate the vena contracts width (VCW) measured usi
ng color Doppler as an index of severity of tricuspid regurgitation (TR).
BACKGROUND The VCW is a reliable measure of mitral and aortic regurgitation
, but its value in measuring TR is uncertain.
METHODS In 71 consecutive patients with TR, the VCW was prospectively measu
red using color Doppler and compared with the results of the flow convergen
ce method and hepatic venous flow, and its diagnostic value for severe TR w
as assessed.
RESULTS The VCW was 6.1 +/- 3.1 mm and was significantly higher in patients
with, than those without, severe TR (9.6 +/- 2.9 vs. 4.2 +/- 1.6 mm, p < 0
.0001). The VCW correlated well with the effective regurgitant orifice (ERO
) by the flow convergence method (r = 0.90, SEE = 0.17 cm(2), p < 0.0001),
even when restricted to patients with eccentric jets (r = 0.93, p < 0.0001)
. The VCW also showed significant correlations with hepatic venous flow (r
= 0.79, p < 0.0001), regurgitant volume (r = 0.77, p < 0.0001) and right ax
ial area (r = 0.46, p < 0.0001). A VCW greater than or equal to 6.5 mm iden
tified severe TR with 88.5% sensitivity and 93.3% specificity. In compariso
n with jet area or jet/right atrial area ratio, the VCW showed better corre
lations with ERO (both p < 0.01) and a larger area under the receiver opera
ting characteristic curve (0.98 vs. 0.88 and 0.85, both p < 0.02) for the d
iagnosis of severe TR.
CONCLUSIONS The VCW measured by color Doppler correlates closely,vith sever
ity of TR This quantitative method is simple, provides a high diagnostic va
lue (superior to that of jet size) for severe TR and represents a useful, t
ool for comprehensive, noninvasive quantitation of TR. (C) 2000 by the Amer
ican College of Cardiology.