Istituto Auxologico Italiano, IRCCS, Department of Cardiac, Neurological and Metabolic Sciences, San Luca Hospital, Milan, Italy.
Department of Management, Information and Production Engineering, University of Bergamo, Dalmine (BG), Italy.
Expert Rev Med Devices. 2021 Nov;18(11):1069-1081. doi: 10.1080/17434440.2021.1990753. Epub 2021 Oct 27.
The tricuspid valve (TV) and the right heart chambers are complex three-dimensional structures that are difficult to assess using tomographic imaging techniques. The progressive aging of the general population and the advancements in treating left-sided heart diseases by transcatheter procedures have contributed to the tricuspid regurgitation (TR) becoming a major public health problem associated with progression to refractory heart failure and poor outcome. Recent advances in multimodality cardiac imaging allow a better understanding of the pathophysiology of TR that may translate in better management of patients.
Three-dimensional echocardiography, cardiac magnetic resonance, and computed tomography provide complementary information to . assess the TV complex; . identify the etiology and the mechanisms of TR; . evaluate its severity and hemodynamic consequences; . explore the remodeling of the right heart chambers; and . properly plan, guide, and monitor the transcatheter interventions aimed to reduce the severity of TR.
We need thorough understanding of both the TV and the right heart chamber geometry and function to understand the pathophysiology of TR. The integrated use of multimodality cardiac imaging is pivotal to assess patients with TR and to identify tailored and timely treatment of TR in properly selected patients.
三尖瓣（TV）和右心腔是复杂的三维结构，使用断层成像技术难以评估。由于一般人群的老龄化以及经导管治疗左心疾病的进步，三尖瓣反流（TR）已成为与难治性心力衰竭和不良预后相关的主要公共卫生问题。多模式心脏成像的最新进展使我们能够更好地了解 TR 的病理生理学，这可能转化为更好的患者管理。
三维超声心动图、心脏磁共振和计算机断层扫描为评估 TV 复合体提供了互补信息；识别 TR 的病因和机制；评估其严重程度和血液动力学后果；探讨右心腔重塑；以及正确规划、指导和监测旨在降低 TR 严重程度的经导管干预措施。
我们需要全面了解 TV 和右心腔的几何形状和功能，以了解 TR 的病理生理学。综合使用多模式心脏成像对于评估 TR 患者以及在适当选择的患者中确定针对 TR 的个体化和及时治疗至关重要。
