Conventional Echocardiography And Real-Time Three Dimensional Echocardiography In The Assessment Of Right Ventricular Function In Patients With Severe Tricuspid Regurgitation

Objectives:We aimed to compare real time three-dimensional echocardiography(RT3DE)derived right ventricular volumes and ejection fraction(RVEF),with traditional echocardiographic parameters,such as tricuspid annular plane systolic excursion(TAPSE).Tei index and the tricuspid systolic peak velocity(S '),in the assessment of right ventricular function in patients with severe tricuspid regurgitation(TR).Method:From February 2016 to February 2017,We enrolled 18 subjects(73.7 ± 9.8 years,BMI 21.1±3.4 Kg/m2)with severe TR,there were 11 women and 7 men among patients.The control group was comprised of 20 patients with average age of 67.3 ± 9.4 years?BMI 23.1 ±3.97 Kg/m2,11 of them were men.All patients with severe TR and control group were assesed by conventional echocardiography and RT-3DE examination.TAPSE was derived by M-mode echocardiography,and TDI technique was used to measure the Tei index and S 'of the tricuspid valve annulus of right ventricular free wall.Right ventricular end-diastolic volume(RVEDV),right ventricular end-systolic volume(RVESV),and RVEF were derived by RT-3DE.The correlation between the routine and RT-3DE parameters in each group were analyzed,and the difference of the conventional and RT-3DE quantitative parameters between the study group with severe TR and the control group were compared.Results:1?The conventional echocardiography derived S' and Tei index of tricuspid valve annulus were significantly correlated with RVEF was derived by RT-3DE in severe TR group(r=0.680,P=0.002 ? r=-0.531,P=0.023).The correlation between S' of tricuspid valve annulus and RVEF was the most significant(r=0.680,P=0.002).2?In the control group,The conventional echocardiography derived TAPSE?S' and Tei index of tricuspid valve annulus were significantly correlated with RVEF(r=0.534,P=0.015?r=-0.657,P=0.002 ? r=0.666,P=0.001).3?In addition,compared with the control group,the S' of tricuspid valve annulus and RVEF values of the severe TR group were significantly reduced(P=0.037;P=0.002).4?There was a significant correlation between TR area and RVEF in severe TR group(r =-0.511,P = 0.030),indicating that the reduction of RVEF was more significant in patients with severe TR with the further increase of TR level.Conclusion:1?In the control group,TAPSE measured by M-mode echocardiography,Tei index and S'of the tricuspid annulus measured by TDI,had significant correlation with RVEF derived by RT-3DE.2?In the severe TR group,Tei index and S 'of the tricuspid annulus measured by TDI,had significant correlation with RVEF derived by RT-3DE.3?Compared with the control group,S' of the tricuspid annulus and RVEF were significantly decreased in the severe TR group.4?In the severe TR group,with the further increase of TR level,the RVEF of the patients with severe TR reduced more significantly.