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Related Experiment Video

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Tricuspid annulus: A spatial and temporal analysis.

Ziyad O Knio1, Mario Montealegre-Gallegos2, Lu Yeh3

  • 1Department of Surgery, Division of Cardiac Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.

Annals of Cardiac Anaesthesia
|October 8, 2016
PubMed
Summary
This summary is machine-generated.

Real-time 3D transesophageal echocardiography reveals the tricuspid annulus (TA) has significant dynamic changes throughout the cardiac cycle. Its primary axis of motion differs from the standard 2D measurement.

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Area of Science:

  • Cardiovascular Imaging
  • Echocardiography
  • Cardiac Mechanics

Background:

  • Traditional 2D echocardiography uses single-frame measurements for tricuspid annulus (TA) dilation, potentially missing dynamic changes.
  • This method may not accurately represent the TA's axis or full range of motion during the cardiac cycle.

Purpose of the Study:

  • To analyze geometric changes in multiple axes of the tricuspid annulus (TA) throughout the cardiac cycle.
  • Utilize real-time 3D transesophageal echocardiography (TEE) for dynamic TA assessment.
  • Compare 3D findings with traditional 2D measurements.

Main Methods:

  • Acquired R-wave-gated 3D TEE images of the TA in 39 patients without RV abnormalities.
  • Reconstructed TA geometry at four cardiac cycle stages (end-systole, mid-systole, end-diastole, mid-diastole).
  • Statistically analyzed changes in TA area, perimeter, axes, and planarity.

Main Results:

  • Significant changes in TA area (P=0.012) and perimeter (P=0.024) were observed over the cardiac cycle.
  • The posterolateral-anteroseptal axis showed significant dynamism (P < 0.001).
  • Significant vertical axis displacement occurred in end-systole, mid-diastole, and mid-systole.

Conclusions:

  • The tricuspid annulus (TA) exhibits selective dynamism during the cardiac cycle.
  • The primary axis of TA dynamism differs from the septolateral (S-L) axis typically measured with 2D TEE.
  • 3D TEE provides a more comprehensive assessment of TA dynamics.