Fisher E A, Goldman M E
Division of Cardiology, Mount Sinai Medical Center, New York, New York 10029.
Am J Cardiol. 1989 Jun 1;63(18):1375-8. doi: 10.1016/0002-9149(89)91051-5.
Functional tricuspid regurgitation (TR) is usually due to pulmonary hypertension with subsequent right ventricular and tricuspid valve anular dilatation. The correlation between anular dilatation and TR severity is unclear. Unfortunately, there is no simple, accurate method of assessing the presence and severity of TR. Real-time (color flow) Doppler echocardiography, a sophisticated but expensive technique, facilitates noninvasive determination of the presence and severity of TR by the area and depth of color-encoded, systolic turbulent reflux into the right atrium. In this study, TR severity (0 to 4+), assessed by color flow Doppler, was correlated with diastolic and systolic tricuspid valve anulus dimension, measured by computerized calipers, from the apical 4-chamber and right ventricular inflow 2-dimensional views. Forty-six patients were studied: 32 with 0 to 2+ TR and 14 with functional 3 to 4+ TR. TR severity correlated significantly with the tricuspid valve anulus in both diastole and systole. The correlation was best in the apical 4-chamber view during systole (r = 0.88, p less than 0.0001). No patient with tricuspid valve anulus in systole less than 3.2 cm or in diastole less than 3.4 cm had severe (3 to 4+) TR. Thus, measurement of the tricuspid valve anulus by 2-dimensional echocardiography is a simple, noninvasive method to identify patients with moderate to severe TR.
功能性三尖瓣反流（TR）通常是由肺动脉高压以及随后的右心室和三尖瓣环扩张引起的。瓣环扩张与TR严重程度之间的相关性尚不清楚。不幸的是，目前尚无简单、准确的方法来评估TR的存在及其严重程度。实时（彩色血流）多普勒超声心动图是一种复杂但昂贵的技术，可通过彩色编码的收缩期湍流反流进入右心房的面积和深度，无创地确定TR的存在及其严重程度。在本研究中，通过彩色血流多普勒评估的TR严重程度（0至4+）与通过计算机卡尺从心尖四腔心和右心室流入二维视图测量的舒张期和收缩期三尖瓣环尺寸相关。对46例患者进行了研究：32例TR为0至2+，14例功能性TR为3至4+。TR严重程度在舒张期和收缩期均与三尖瓣环显著相关。在收缩期的心尖四腔心视图中相关性最佳（r = 0.88，p < 0.0001）。收缩期三尖瓣环小于3.2 cm或舒张期小于3.4 cm的患者均无严重（3至4+）TR。因此，二维超声心动图测量三尖瓣环是一种简单、无创的方法，可用于识别中重度TR患者。
