Daniels S J, Mintz G S, Kotler M N
Am J Cardiol. 1983 Feb;51(3):492-6. doi: 10.1016/s0002-9149(83)80086-1.
From March 1977 through April 1982, 2-dimensional echocardiography detected 372 patients with rheumatic mitral valve disease. Of these patients, 23 (6%) had tricuspid valve involvement. Two-dimensional echocardiographic criteria of rheumatic tricuspid valve disease included thickened leaflets with restriction in motion, diastolic doming, and encroachment of the leaflet tips on the ventricular inlet. These criteria provided a sensitivity of 100%, a specificity of 90%, a predictive accuracy of 21%, and a negative predictive value of 100% in diagnosing hemodynamically significant tricuspid stenosis. Hemodynamic variables in patients with rheumatic tricuspid valve disease (Group I) were compared with those in patients with no rheumatic tricuspid disease (Group II). The only significant difference was mean right atrial pressure (15 +/- 7 mm Hg versus 11 +/- 5 mm Hg, p less than 0.02). Both groups were classified into patients with (A) and without (B) significant tricuspid regurgitation (TR). There was no significant difference in any hemodynamic variable when Group IA was compared with Group IIA. In addition, there was no difference in any hemodynamic variable when patients with functional TR (Group IIA) were compared with those with rheumatic mitral valvular disease without TR (Group IIB). Two-dimensional echocardiography and cardiac catheterization provide complementary diagnostic information in these patients.
从1977年3月至1982年4月，二维超声心动图检查出372例风湿性二尖瓣疾病患者。其中，23例（6%）有三尖瓣受累。风湿性三尖瓣疾病的二维超声心动图标准包括瓣叶增厚、活动受限、舒张期圆顶样改变以及瓣叶尖端侵入心室入口。这些标准在诊断血流动力学显著的三尖瓣狭窄时，敏感性为100%，特异性为90%，预测准确性为21%，阴性预测值为100%。将风湿性三尖瓣疾病患者（第一组）的血流动力学变量与无风湿性三尖瓣疾病患者（第二组）的进行比较。唯一显著的差异是平均右心房压力（15±7 mmHg对11±5 mmHg，p<0.02）。两组均分为有（A）和无（B）显著三尖瓣反流（TR）的患者。比较第一组A与第二组A时，任何血流动力学变量均无显著差异。此外，比较功能性TR患者（第二组A）与无TR的风湿性二尖瓣疾病患者（第二组B）时，任何血流动力学变量也无差异。二维超声心动图和心导管检查为这些患者提供了互补的诊断信息。
