Introduction
Methods
Population
Two-dimensional TTE
Three-dimensional TTE
Imaging analysis
Statistical analysis
Results
Baseline characteristics of the study population
Variable | n (%) |
---|---|
Primary TR, overall | 44(44.4) |
Rheumatic changes | 28(28.3) |
Congenital changes | 7(7.1) |
Trauma | 4(4.0) |
Endocarditis | 3(3.0) |
Degeneration | 2(2.0) |
Secondary TR, overall | 55(55.6) |
Left-sided heart disease | 37(39.4) |
Atrial Fibrillation | 8(8.1) |
Pulmonary arterial hypertension | 5(5.1) |
Right ventricle dysfunction | 3(3.0) |
Pacemaker | 2(2.0) |
Variable | Primary TR | Secondary TR | P | ||
---|---|---|---|---|---|
Non-severe (n = 24) | Severe (n = 20) | Non-severe (n = 28) | Severe (n = 27) | ||
Sex,Female(%) | 15(62.5) | 10(50.0) | 18(64.3) | 18(66.7) | 0.677 |
Age(y) | 54.5 ± 11.6 | 56.3 ± 13.1 | 66.4 ± 7.5* | 61.9 ± 9.6 | 0.010 |
Weight(kg) | 58.2 ± 8.3 | 61.2 ± 12.6 | 59.8 ± 11.1 | 63.0 ± 21.2 | 0.729 |
Height(cm) | 162.3 ± 6.7 | 164.2 ± 8.9 | 162.1 ± 9.1 | 156.0 ± 25.2 | 0.319 |
BSA(m2) | 1.6 ± 0.1 | 1.6 ± 0.2 | 1.6 ± 0.2 | 1.6 ± 0.2 | 0.702 |
Atrial Fibrillation(%) | 12(50.0) | 7(35.0) | 9(32.1) | 12(44.4) | 0.544 |
TR jet location, centric(%) | 6(25.0) | 6(30.0) | 15(53.6) | 18(66.7) | 0.417 |
Malcoaptation or flail leaflet(%) | 10(41.7) | 15(75.0) | 3(10.7) | 10(37.0) | < 0.001 |
VCW,≥0.7 cm(%) | 4(16.7) | 19(95.0) | 3(10.7) | 23(85.2) | < 0.001 |
PISA radius, > 0.9 cm(%) | 0(0) | 4(20.0) | 0(0) | 1(3.7) | 0.007 |
TR VTI(m) | 0.73 ± 0.20 | 0.61 ± 0.21 | 0.89 ± 0.21+ | 0.67 ± 0.20 | < 0.001 |
TR Vmax(m/s) | 2.40 ± 0.56 | 2.17 ± 0.65 | 2.69 ± 0.62+ | 2.23 ± 0.60 | 0.013 |
RVOT VTI(m) | 0.12 ± 0.02 | 0.12 ± 0.03 | 0.15 ± 0.05 | 0.14 ± 0.05 | 0.350 |
S(RVOT)(cm2) | 3.16 ± 0.60 | 3.93 ± 1.61 | 3.48 ± 0.87 | 3.28 ± 0.87 | 0.237 |
SV(RVOT)(ml) | 38.8 ± 9.3 | 46.7 ± 16.0 | 50.3 ± 22.0 | 42.4 ± 10.9 | 0.207 |
RVEDV(ml) | 107.9 ± 21.8+ | 173.4 ± 46.6 | 129.2 ± 34.9*,+ | 162.8 ± 43.5 | < 0.001 |
RVESV(ml) | 44.9 ± 13.5 | 64.9 ± 26.9 | 57.5 ± 28.6 | 65.6 ± 20.7 | 0.088 |
SV(RV)(ml) | 63.0 ± 12.8+ | 107.5 ± 29.6 | 70.4 ± 21.1+ | 97.4 ± 36.9 | < 0.001 |
Rvol(ml) | 24.2 ± 12.5+ | 60.9 ± 23.1 | 20.8 ± 10.8+ | 53.8 ± 31.4 | < 0.001 |
Hepatic vein systolic reversal(%) | 2(8.3) | 14(70.0) | 2(7.1) | 15(55.6) | < 0.001 |
Dilated right ventricle with preserved function(%) | 8(33.3) | 15(75.0%) | 7(25.0) | 23(85.2) | < 0.001 |
2D PISA EROA(cm2) | 0.12 ± 0.02+ | 0.85 ± 0.38 | 0.12 ± 0.02+ | 0.57 ± 0.10 | 0.008 |
3D PISA EROA(cm2) | 0.26 ± 0.04+ | 1.10 ± 0.46 | 0.23 ± 0.03*,+ | 0.92 ± 0.17 | < 0.001 |
3D Rvol EROA(cm2) | 0.39 ± 0.04+ | 1.27 ± 0.28 | 0.23 ± 0.03+ | 0.83 ± 0.13 | 0.015 |
TR quantification by the 3D PISA EROA compared with 2D PISA EROA and 3D Rvol EROA
Variable | 2D PISA EROA vs 3D PISA EROA | 3D PISA EROA vs 3D Rvol EROA | ||
---|---|---|---|---|
r | P | r | P | |
Total patient population | 0.878 | < 0.01 | 0.884 | < 0.01 |
Primary TR | 0.848 | < 0.01 | 0.866 | < 0.01 |
Secondary TR | 0.88 | < 0.01 | 0.897 | < 0.01 |
With atrial fibrillation | 0.721 | < 0.01 | 0.59 | < 0.01 |
Without atrial fibrillation | 0.97 | < 0.01 | 0.97 | < 0.01 |
Eccentric TR | 0.784 | < 0.01 | 0.692 | < 0.01 |
Centric TR | 0.97 | < 0.01 | 0.973 | < 0.01 |
Diagnostic value of 3D PISA EROA to differentiate non-severe TR and severe TR
Incremental value of 3D PISA EROA for integrated approach to grade TR severity
Variable | B | Std. Error | Beta | t | P | VIF |
---|---|---|---|---|---|---|
Etiology(primary/ secondary) | −0.162 | 0.089 | −0.127 | −1.826 | 0.071 | 1.103 |
Sex(male/female) | −0.111 | 0.092 | −0.085 | −1.207 | 0.231 | 1.135 |
Atrial fibrillation (with/without) | −0.002 | 0.092 | −0.001 | − 0.018 | 0.986 | 1.151 |
TR jet location (eccentric/centric) | 0.014 | 0.095 | 0.010 | 0.144 | 0.885 | 1.155 |
VCW | −0.291 | 0.104 | −0.230 | −2.802 | < 0.01 | 1.535 |
PISA radius | −1.162 | 0.210 | −0.402 | −5.539 | < 0.01 | 1.199 |
TR VTI | −0.467 | 0.357 | 0.179 | 1.308 | 0.194 | 4.286 |
TR Vmax | −0.464 | 0.133 | −0.460 | −3.477 | < 0.01 | 3.981 |
Hepatic vein systolic reversal (with/ Without) | −0.308 | 0.107 | −0.229 | −2.862 | < 0.01 | 1.459 |
Dilated right ventricle with preserved function (with/without) | 0.011 | 0.099 | 0.009 | 0.110 | 0.913 | 1.384 |