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Tricuspid valve prolapse diagnosed by cross-sectional echocardiography
Insights
In patients with mitral valve prolapse, nearly half showed tricuspid valve prolapse. This condition, affecting multiple leaflets, correlated with increased symptoms and abnormal physical findings.
Area of Science:
- Cardiology
- Echocardiography
- Valvular Heart Disease
Background:
- Mitral valve prolapse (MVP) is a common valvular condition.
- The prevalence and characteristics of tricuspid valve (TV) involvement in MVP patients are not fully understood.
Purpose of the Study:
- To investigate the prevalence and echocardiographic features of tricuspid valve prolapse (TVP) in patients with mitral valve prolapse (MVP).
- To compare symptomatology and physical findings between patients with MVP alone and those with both MVP and TVP.
Main Methods:
- Cross-sectional echocardiography was performed in 64 patients with MVP and 16 controls.
- Specific views (apical, longitudinal right ventricular inflow tract) were used to assess the tricuspid valve.
- Tricuspid valve prolapse was defined as leaflets lying above the tricuspid valve ring in systole.
Main Results:
- Tricuspid valve prolapse was identified in 31/64 (48%) of patients with MVP, compared to 0% in controls.
- The right ventricular inflow tract view was more effective in detecting TVP than the apical view.
- Of those with TVP, 29/31 had prolapse of at least two tricuspid valve leaflets.
- Patients with both MVP and TVP exhibited more symptoms and abnormal physical findings than those with MVP alone.
Conclusions:
- Tricuspid valve prolapse is common in patients with mitral valve prolapse.
- The right ventricular inflow tract view is optimal for diagnosing TVP.
- Concomitant tricuspid valve prolapse in MVP patients is associated with a higher clinical burden.
Abstract:
Cross-sectional echocardiography utilizing the apical and longitudinal right ventricular inflow tract views was used to investigate the tricuspid valve in 64 patients with mitral valve prolapse and 16 controls who had no angiographic or echocardiographic evidence of mitral valve prolapse. The tricuspid valve leaflets and their coaptation point in systole were found to be below (towards the right ventricular apex) the level of the tricuspid valve ring in systole in all controls. Tricuspid valve prolapse, defined as the leaflet(s) of the tricuspid valve lying above the tricuspid valve ring level within the right atrium, was seen in 31/64(48 percent) of patients with mitral valve prolapse. The right ventricular inflow tract view demonstrated tricuspid valve prolapse most readily compared to the apical view, and 29 of the 31 patients with tricuspid valve prolapse had prolapse of at least two leaflets of the tricuspid valve. The 31 patients with both mitral and tricuspid valve prolapse, when compared to the 33 patients with mitral valve prolapse alone, had more symptomatology and abnormal physical findings.