EACVI Survey on the Current Multi-Modality Imaging Practice in Patients with Tricuspid Regurgitation

Area of Science:

• Cardiovascular Imaging
• Echocardiography
• Cardiac MRI

Background:

• Tricuspid regurgitation (TR) assessment requires standardized imaging protocols.
• Current practice patterns for TR imaging vary significantly.
• The European Association of Cardiovascular Imaging (EACVI) aims to standardize cardiac imaging.

Purpose of the Study:

• To evaluate current practice patterns in imaging assessment of tricuspid regurgitation (TR).
• To assess the adoption of recent TR classifications and quantitative right heart assessment.
• To identify barriers to advanced imaging modalities in TR evaluation.

Main Methods:

• An online questionnaire was distributed to 530 respondents from 69 countries via EACVI channels.
• The survey focused on conventional and advanced echocardiography, 3D imaging, and cardiac magnetic resonance (CMR).
• Data collected included modality usage, adoption of TR severity schemes, and barriers to quantitative assessment.

Main Results:

• Transthoracic echocardiography (TTE) is widely used; transesophageal (TOE) and 3D echocardiography use is variable.
• RV strain and ejection fraction are underutilized due to time and software constraints.
• TR quantification relies on color Doppler, with advanced methods reserved for select cases; classification schemes show inconsistent adoption.

Conclusions:

• Significant heterogeneity exists in TR imaging practices.
• Adoption of quantitative and advanced imaging for TR severity and right heart assessment is slow.
• Improved access to advanced imaging and dissemination of standards are crucial for consistent TR assessment.