Nemes Attila, Kormányos Árpád, Rácz Gergely, Ruzsa Zoltán, Achim Alexandru, Ambrus Nóra, Lengyel Csaba
Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary.
Front Cardiovasc Med. 2023 Sep 4;10:1140599. doi: 10.3389/fcvm.2023.1140599. eCollection 2023.
The tricuspid valve and its annulus (TA) and the right atrium (RA) play a significant role in regulating blood flow in the right heart. However, their effect on each other is not fully understood even in normal circumstances. Three-dimensional (3D) speckle-tracking echocardiography (3DSTE) is able to simultaneously assess TA and RA at the same time in a non-invasive way. The present study aimed to examine associations between tricuspid annular (TA) dimensions and right atrial (RA) volumes in healthy adults by 3DSTE.
The present study comprised 144 healthy subjects (mean age: 34.4 ± 12.6 years, 72 males), who participated in this study on a voluntary basis for screening between 2011 and 2015. In all subjects, electrocardiography, two-dimensional Doppler echocardiography and 3DSTE have been performed.
With increasing end-systolic maximum RA volume, all end-systolic and end-diastolic TA dimensions showed simultaneous increase, but in various degrees resulting in (non-significant) reduction of TA functional properties. Similarly, with increasing diastolic pre-atrial contraction and minimum RA volumes, TA dimensions increased simultaneously (except end-diastolic TA diameter), but in various degrees resulting in reduced TA fractional shortening and fractional area change. With increasing RA dimensions, end-systolic and end-diastolic TA dimensions showed simultaneous increase, but in different, sometimes not significant degrees. While RA stroke volumes showed increasing pattern with TA dilation, RA emptying fractions have not changed substantially.
3DSTE is suitable for non-invasive assessment of TA dimensions and RA volumes at the same time using the same 3D echocardiographic dataset. Significant associations between TA size and RA volumes exist in healthy circumstances. Strong associations in case of dilation of TA in the presence of higher RA volumes could partly explain functional tricuspid regurgitation later developing in subjects in sinus rhythm.
三尖瓣及其瓣环（TA）和右心房（RA）在调节右心血流方面发挥着重要作用。然而，即使在正常情况下，它们之间的相互作用也尚未完全明确。三维（3D）斑点追踪超声心动图（3DSTE）能够以非侵入性方式同时评估TA和RA。本研究旨在通过3DSTE检测健康成年人三尖瓣环（TA）尺寸与右心房（RA）容积之间的关联。
本研究纳入了144名健康受试者（平均年龄：34.4±12.6岁，男性72名），他们于2011年至2015年自愿参与本研究进行筛查。所有受试者均进行了心电图、二维多普勒超声心动图和3DSTE检查。
随着收缩末期右心房最大容积增加，所有收缩末期和舒张末期TA尺寸均同时增加，但程度各异，导致TA功能特性（无显著）降低。同样，随着舒张期房性早搏前和右心房最小容积增加，TA尺寸同时增加（舒张末期TA直径除外），但程度不同，导致TA缩短分数和面积变化分数降低。随着右心房尺寸增加，收缩末期和舒张末期TA尺寸同时增加，但程度不同，有时不显著。虽然右心房每搏量随TA扩张呈增加趋势，但右心房排空分数基本未变。
3DSTE适用于使用同一3D超声心动图数据集同时对TA尺寸和右心房容积进行非侵入性评估。在健康情况下，TA大小与右心房容积之间存在显著关联。在窦性心律受试者中，TA扩张且右心房容积较高时的强关联可能部分解释了后期发生的功能性三尖瓣反流。
