Shimada R, Takeshita A, Nakamura M, Tokunaga K, Hirata T
Am J Cardiol. 1984 Jan 1;53(1):164-8. doi: 10.1016/0002-9149(84)90703-3.
A decreased diastolic slope (EF slope) of the tricuspid valve on the M-mode echocardiogram may not indicate the presence of tricuspid stenosis (TS). To explore diagnostic echocardiographic signs of TS, we examined an M-mode and 2-dimensional (2-D) echocardiogram in 9 patients with documented TS of rheumatic origin and in 14 patients with rheumatic heart disease who showed a decreased EF slope (less than 40 mm/s) but did not have TS. By M-mode echocardiography, the EF slope was not different between patients with TS (24.4 +/- 2.2 mm/s) and those without TS (27.4 +/- 2.0 mm/s). The early diastolic excursion (DE amplitude) of the tricuspid valve was significantly lower (p less than 0.001) in patients with TS (7.6 +/- 1.0 mm) than in patients without TS (13.9 +/- 0.6 mm). Two-dimensional echocardiograms of the tricuspid valve revealed diastolic doming in all patients with TS. Diastolic doming of the tricuspid valve was detected most often (all of 7 patients) in the apical 4-chamber view. In contrast, no patients without TS who had a decreased EF slope on the M-mode echocardiogram showed diastolic doming. These data suggest that a reduced DE amplitude of less than or equal to 10 mm associated with a decreased EF slope on the M-mode echocardiogram and diastolic doming of the tricuspid valve on the 2-D echocardiogram are useful echocardiographic signs in the diagnosis of TS.
M型超声心动图上三尖瓣舒张期斜率（EF斜率）降低可能并不表明存在三尖瓣狭窄（TS）。为了探索TS的超声心动图诊断征象，我们对9例有风湿性起源的确诊TS患者和14例风湿性心脏病患者进行了M型和二维（2-D）超声心动图检查，后者EF斜率降低（小于40mm/s）但无TS。通过M型超声心动图检查，TS患者（24.4±2.2mm/s）和无TS患者（27.4±2.0mm/s）的EF斜率无差异。TS患者三尖瓣舒张早期偏移（DE幅度）（7.6±1.0mm）显著低于无TS患者（13.9±0.6mm）（p＜0.001）。三尖瓣的二维超声心动图显示所有TS患者均有舒张期圆顶状改变。在心底四腔心切面，三尖瓣舒张期圆顶状改变最常被检测到（7例患者均有）。相比之下，M型超声心动图EF斜率降低的无TS患者均未显示舒张期圆顶状改变。这些数据表明，M型超声心动图上与EF斜率降低相关的DE幅度降低至小于或等于10mm以及二维超声心动图上三尖瓣舒张期圆顶状改变是诊断TS有用的超声心动图征象。
