Cammalleri Valeria, Carpenito Myriam, De Stefano Domenico, Ussia Gian Paolo, Bono Maria Caterina, Mega Simona, Nusca Annunziata, Cocco Nino, Nobile Edoardo, De Filippis Aurelio, Vitez Luka, Quattrocchi Carlo Cosimo, Grigioni Francesco
Unit of Cardiovascular Science, Department of Medicine, Campus Bio-Medico University, 00128 Rome, Italy.
Unit of Diagnostic Imaging and Interventional Radiology, Campus Bio-Medico University, 00128 Rome, Italy.
J Clin Med. 2022 May 17;11(10):2825. doi: 10.3390/jcm11102825.
Computed tomography (CT) is the recommended imaging technique for defining the anatomical suitability for current transcatheter technologies and planning tricuspid valve (TV) intervention. The aim of the Tricuspid Regurgitation IMAging (TRIMA) study was to assess the geometrical characteristics of the TV complex using novel CT parameters.
This prospective, single-center study enrolled 22 consecutive patients with severe tricuspid regurgitation, who underwent a cardiac CT study dedicated to the right chambers. The following variables were obtained: annulus area and perimeter, septal-lateral and antero-posterior diameters, tenting height, and anatomical regurgitant orifice area. Moreover, the following novel annular parameters were assessed: distance between commissures, distance between TV centroid and commissures, and angles between centroid and commissures.
A significant phasic variability during the cardiac cycle existed for all variables except for eccentricity, angles, and distance between the postero-septal and antero-posterior commissure and distance between the centroid and antero-posterior commissure. There was a significant relationship between the TV annulus area and novel annular parameters, except for annular angles. Additionally, novel annular variables were found to predict the annulus area.
These novel additional variables may provide an initial platform from which the complexity of the TV annular morphology can continue to be better understood for further improving transcatheter therapies.
计算机断层扫描（CT）是用于确定当前经导管技术的解剖学适用性以及规划三尖瓣（TV）介入治疗的推荐成像技术。三尖瓣反流成像（TRIMA）研究的目的是使用新的CT参数评估TV复合体的几何特征。
这项前瞻性单中心研究连续纳入了22例严重三尖瓣反流患者，他们接受了专门针对右心房室的心脏CT检查。获取了以下变量：瓣环面积和周长、间隔-侧壁和前后径、帐篷高度以及解剖学反流口面积。此外，还评估了以下新的瓣环参数：瓣叶连合处之间的距离、TV质心与瓣叶连合处之间的距离以及质心与瓣叶连合处之间的角度。
除了偏心度、角度、后间隔与前后连合处之间的距离以及质心与前后连合处之间的距离外，所有变量在心动周期中均存在显著的相位变化。除了瓣环角度外，TV瓣环面积与新的瓣环参数之间存在显著关系。此外，发现新的瓣环变量可预测瓣环面积。
这些新的额外变量可能提供一个初始平台，从中可以继续更好地理解TV瓣环形态的复杂性，以进一步改进经导管治疗。
