Tricuspid valve geometry in patients with functional tricuspid regurgitation: A three-dimensional echocardiographic study

Introduction Tricuspid valve (TV) has a complex anatomy causing some difficulties in echocardiographic evaluation. In this study, we sought to assess the geometry of TV in patients with functional tricuspid regurgitation (TR) by the implementation of 2- and 3-dimennsional (2D and 3D) echocardiography. Methods In a case-control study, the geometrical features of TV were evaluated in forty patients with functional TR using echocardiographic examinations, and those data compared with twenty-five age- and sex-matched healthy individuals. Results The mean age of patients was 50 +/- 12 years, and 75% were female. All echocardiographic features of TV geometry were significantly greater in TR compared to control group. The 3D evaluation of TV annulus showed that the annulus shape was more circular in the TR compared to the control group. When compared patients with moderate and severe TR, there was a significant difference between groups regarding the size of the TV septolateral annulus diameter (3.5 +/- 0.4 vs 3.9 +/- 0.7 cm; P = .048), and the angle between mitral valve and TV annuluses (12.5 +/- 4.3 vs 17 +/- 9o; P = .048). Tenting areas measured by 2D echocardiography and obtained by TomTec software were significantly greater in severe TR compared to moderate TR group. The diameter of TV by 2D echocardiography was significantly higher in atrial fibrillation than that in sinus rhythm group among patients with TR. Conclusions The implementation of 3D echocardiography is useful in the determination of TV geometry in patients with functional TR. The accurate evaluation of anatomical features of TV might provide valuable tools in the evaluation of patients with functional TR.