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Echocardiographic parameters recommended for assessing the severity of tricuspid regurgitation: concordance and

Yuanfeng Wu1,2,3, Fangmin Meng4, Yu Liu4

  • 1Department of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai, China.

Quantitative Imaging in Medicine and Surgery
|August 15, 2023
PubMed

Insights

Assessing tricuspid regurgitation (TR) severity with echocardiography shows limited concordance among parameters. Focusing on effective regurgitant orifice area (EROA), regurgitant volume (RVol), and vena contracta width (VCW) improves agreement, aligning with current guidelines.

Area of Science:

  • Cardiology
  • Echocardiography
  • Cardiac Imaging

Background:

  • Current guidelines recommend multiple echocardiographic indices for tricuspid regurgitation (TR) severity assessment.
  • Discordance between qualitative and quantitative echocardiographic methods for TR is common in clinical practice.
  • The reasons for discordance among TR assessment parameters remain incompletely understood.

Purpose of the Study:

  • To evaluate the concordance of various echocardiographic parameters used for assessing tricuspid regurgitation (TR) severity.
  • To determine if a subset of parameters offers better agreement for TR severity assessment.

Main Methods:

  • 127 patients with TR were prospectively enrolled.
  • Eight 2D echocardiographic parameters were assessed: PISA-derived RVol, PISA-derived EROA, PISA radius, VCW, color Doppler jet area, tricuspid annular diameter, IVC diameter, and peak E wave.
  • Concordance scores were calculated, and data were categorized into complete, high, and low concordance groups.

Main Results:

  • The overall mean concordance score for TR assessment was 81%±17%.
  • Complete concordance was observed in 38% of patients, with low concordance prevalent in severe TR cases.
  • Concordance significantly improved when considering only EROA, RVol, and VCW, achieving complete agreement in 77% of patients.

Conclusions:

  • Echocardiographic parameter concordance for assessing TR severity is limited.
  • Utilizing EROA, RVol, and VCW enhances concordance, supporting current guideline recommendations for TR evaluation.
Abstract

Keywords:
Tricuspid regurgitation (TR)discordanceechocardiography

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