[Pathophysiology of tricuspid insufficiency: analysis of the motion of the tricuspid valve annulus using 2-dimensional echocardiography].

We investigated tricuspid annular motion in patients with pulmonary hypertension and in normal controls to determine the greatest minimal diameter and percentage shortening of the tricuspid annulus required for functional tricuspid regurgitation. 73 patients were studied by 2-dimensional echocardiography: a control group of 30 patients (group I); 43 patients had pulmonary hypertension, 9 of whom were still in sinus rhythm (group II), the other 34 patients had atrial fibrillation. 19 of these showed competent tricuspid valve with contrast echocardiography (group III), whereas the 15 remaining patients had functional tricuspid regurgitation (group IV). An analysis of shape and position changes of tricuspid annulus during the heart cycle was performed. The maximal diameter (mm/m2) in the apical 4 chamber view was in group I 17.5 +/- 1.4, in group II 20.7 +/- 3.2 (vs. group I p less than 0.05), in group III 19.0 +/- 3.4 (vs. group II NS) and in group IV 25.7 +/- 6.0 (vs. group III p less than 0.001). The values for the minimal annular diameter (mm/m2) were in group I 13.7 +/- 1.2, in group II 17.4 +/- 3.5 (vs. group I p less than 0.01), in group III 16.6 +/- 3.3 (vs. group II NS) and in group IV 23.6 +/- 5.7 (vs. group p less than 0.001). The percent decrease (%) in group I was 21.5 +/- 3.3, in group II 17.0 +/- 6.9 (vs. group I p less than 0.05), in group III 12.8 +/- 4.7 (vs. group II p less than 0.05) and in group IV 7.9 +/- 3.4 (vs. group III p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)