Department of Cardiothoracic Surgery, University Hospital Centre Limoges, Dupuytren 2, 16 rue Bernard Descottes, 87042, Limoges Cedex, France.
University Paris-Descartes, Paris, France.
Cardiovasc Eng Technol. 2022 Oct;13(5):699-711. doi: 10.1007/s13239-021-00604-0. Epub 2022 Feb 15.
To improve knowledge of the tricuspid valve and right atrioventricular junction (RAVJ) coupling, four-dimensional (4D) imaging is mandatory (3D + time). Based on multiphase cardiac-volume computed tomography (CT) and innovative 4D analysis, we proposed to assess dynamical features of tricuspid annulus (TA) in relation to the right ventricle (RV) and right atrial (RA) functions.
Cardiac-volume CT data sets through time were obtained in 30 healthy patients (Male 57%, mean age 57 ± 11 years). Using an in-house software, 3D semi-automated delineation of 18 points around TA perimeter were defined through 10 cardiac phases within RR interval and used to calculate TA features such as 3D/2D areas, perimeters, 360°-diameters and vertical deformation. RV and RA inner contours were also delineated. Bi-dimensional parameters were compared with multiplanar reconstruction (MPR) measurements.
TA was elliptical in horizontal projection with a maximal eccentricity index (EcI) of 0.58 ± 0.12; and saddle-shaped in vertical projection with a horn nearby the antero-septal commissure. This feature remained throughout the cardiac cycle, but TA was more planar and less circular in late diastole (TA-height: 4.53 ± 1.06 mm, EcI = 0.61 ± 0.14) when TA 3D area and perimeter reached a maximum of 7.05 ± 1.23 and 7.48 ± 0.93cm/m, respectively. Correlations between minimal and maximal TA 3D areas and TA Projected 2D areas were excellent (r = 0.993 and r = 0.995, p < 0.001). TA 2D area measurements by MPR overestimated the projected values by 22 to 24%. Correlation between RV concentric strain and TA maximal diameter shortening was r = 0.452 (p = 0.01).
Cardiac-volume CT improves physiological knowledge of the relationships between the RAVJ components in healthy subjects.
为了提高对三尖瓣和右房室结（RAVJ）连接的认识，必须进行四维（4D）成像（3D+时间）。基于多相心脏容积计算机断层扫描（CT）和创新的 4D 分析，我们提出评估三尖瓣环（TA）与右心室（RV）和右心房（RA）功能相关的动力学特征。
在 30 名健康患者中获得通过时间的心脏容积 CT 数据集（男性占 57%，平均年龄 57±11 岁）。使用内部软件，在 RR 间期内的 10 个心动周期内，通过 18 个 TA 周长周围的 3D 半自动描绘定义了 18 个点，用于计算 TA 特征，如 3D/2D 面积、周长、360°直径和垂直变形。还描绘了 RV 和 RA 的内轮廓。比较了二维参数与多平面重建（MPR）测量值。
TA 在水平投影中呈椭圆形，最大偏心指数（EcI）为 0.58±0.12；在垂直投影中呈鞍形，前隔交界处附近有一个角。这个特征在整个心动周期中都存在，但在舒张晚期，TA 更平坦，更圆（TA 高度：4.53±1.06mm，EcI=0.61±0.14），此时 TA 的 3D 面积和周长分别达到最大值 7.05±1.23 和 7.48±0.93cm/m。最小和最大 TA 3D 面积与 TA 投影 2D 面积之间的相关性极好（r=0.993 和 r=0.995，p<0.001）。MPR 测量的 TA 2D 面积比投影值高估了 22%至 24%。RV 同心应变与 TA 最大直径缩短之间的相关性为 r=0.452（p=0.01）。
心脏容积 CT 提高了健康受试者中 RAVJ 成分之间关系的生理知识。
