Right ventricular remodeling determines tricuspid valve geometry and the severity of functional tricuspid regurgitation: a real-time 3-dimensional echocardiography study
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Updated: Jun 7, 2026

Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography
Published on: October 28, 2020
Jong-Min Song1, Min-Kyoung Jang, Yun-Jeong Kim
1Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Background And Objectives:
Right ventricle (RV) remodeling can determine tricuspid valve (TV) geometry and the severity of functional tricuspid regurgitation (TR).
Subjects And Methods:
In 53 patients with various degrees of functional TR and in sinus rhythm, RV and TV geometries were analyzed using real-time 3-dimensional echocardiography, including tenting angles of 3 leaflets, septal-lateral and antero-posterior tricuspid annulus diameters and inlet RV dimensions, mid-RV septal-lateral dimension, and the distance between annulus and apex. A mid-systole frame when the TV tenting is smallest was selected for the analysis. RV end-diastolic and end-systolic volumes were measured. The severity of functional TR was determined by distal jet area.
Results:
TR distal jet area was mainly determined by septal-lateral annulus diameter (p<0.001) RV inlet dimension (p=0.015), RV end-systolic volume (p=0.010), septal (p=0.019), and anterior leaflet tenting angles (p=0.045) by multiple stepwise linear regression analysis. Leaflet tenting angles were mainly determined by septal-lateral RV inlet dimension. Septal-lateral annulus diameter was determined by septal-lateral RV inlet dimension (p<0.001) and mid RV dimension (p=0.033), whereas antero-posterior annulus diameter was determined by antero-posterior RV inlet dimension (p<0.001).
Conclusion:
Functional TR severity is determined by septal-lateral annulus and RV dilation, and tenting of septal and anterior leaflets. TV leaflet tenting is mainly determined by septal-lateral RV inlet dilation, and tricuspid annulus dilation is closely linked with inlet RV dilation.
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