Abstract
Background
We aimed to comprehensively assess tricuspid valve anatomy and to determine factors
associated with the more advanced stages beyond severe TR (i.e., massive to torrential).
Methods
We retrospectively analyzed the pre-procedural cardiac CT images in patients with
≥severe TR using 3mensio software. The tricuspid valve annulus size, right-atrial
and right-ventricular dimensions, tenting height, and leaflet angles were measured.
Results
A total of 103 patients were analyzed. The mean effective regurgitant orifice area
was 61.7 ± 31.5 mm2, vena contracta was 13.1 ± 4.6 mm, and massive/torrential TR was observed in 62
patients. Compared to patients with severe TR, patients with massive/torrential TR
had a larger tricuspid annulus area (18.6 ± 3.4 cm2 vs. 20.6 ± 5.3 cm2, p = 0.037), right atrial short-axis diameter (66.1 ± 9.1 mm vs. 70.6 ± 9.9 mm,
p = 0.022), increased tenting height (8.8 ± 3.6 mm vs. 10.7 ± 3.7 mm, p = 0.014),
and greater leaflet angles (anterior leaflet: 22 ± 9° vs. 32 ± 13°, p < 0.001;
posterior leaflet: 22 ± 11° vs. 30 ± 11°, p = 0.003). In the multivariable logistic
regression model, the angle of anterior leaflet (OR 1.08, 95%CI 1.03–1.14, p = 0.004)
and posterior leaflet (OR 1.07, 95%CI 1.02–1.13, p = 0.007) were associated with
massive/torrential TR. Additionally, patients with massive/torrential TR more often
had TR jets from non-central/non-anteroseptal commissure (34% vs. 76%, p < 0.001).
In the multivariable model, the greater angle of the leaflets and more elliptical
annulus were associated with non-central/non-anteroseptal TR jets.
Conclusions
Anterior and posterior leaflet angles are significant factors associated with massive/torrential
TR. Furthermore, leaflet angles and ellipticity of the tricuspid valve are associated
with the location of TR jets.
Graphical abstract
Graphical Abstract
Keywords
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Article info
Publication history
Published online: January 25, 2023
Accepted:
January 24,
2023
Received in revised form:
January 8,
2023
Received:
July 4,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.
