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Dynamic Systolic Changes in Tricuspid Regurgitation Vena Contracta Size and Proximal Isovelocity Surface Area in Hypoplastic Left Heart Syndrome: A Three-Dimensional Color Doppler Echocardiographic Study
- Source :
- Journal of the American Society of Echocardiography. 34:877-886
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- Background The aims of this study were to investigate the dynamic changes in the vena contracta (VC) and proximal isovelocity surface area (PISA) through systole in patients with hypoplastic left heart syndrome and tricuspid regurgitation and to identify the stage of systole (early, mid, or late) in which VC and PISA radius are optimal. Methods Twenty-eight patients with hypoplastic left heart syndrome were prospectively studied using continuous two-dimensional (2D) and three-dimensional (3D) echocardiography. Two-dimensional VC width, 3D VC area, and PISA radii (2D and 3D) were measured frame by frame throughout systole. The maximal 2D VC width, 3D VC area, and PISA radii in the first, middle, and last thirds of systole were compared, and correlations were explored with 3D tricuspid annular areas, right atrial volumes, and right ventricular volumes. Results In all, 35 data sets that met inclusion criteria were analyzed. On frame-by-frame analysis, maximal 2D VC width and 3D VC area were found in the first third of systole in 17% and 20% of studies, in the second third in 34% and 31%, and in the final third in 49% and 49%. Similarly, the maximal 2D and 3D PISA radii were found in the first third of systole in 26% and 17% of studies, in the second third in 28% and 34%, and in the final third in 46% and 49%. Conclusions In hypoplastic left heart syndrome, detailed temporal analysis of tricuspid regurgitation–associated VC and PISA by 2D and 3D echocardiography reveals no reliable pattern predicting when in systole these parameters peak. Frame-by-frame measurement is necessary for identification of maximal VC and PISA radius on 2D and 3D color Doppler echocardiography because the severity of tricuspid regurgitation could be underestimated because of temporal variability in VC and PISA.
- Subjects :
- medicine.medical_specialty
Proximal isovelocity surface area
Systole
Echocardiography, Three-Dimensional
Regurgitation (circulation)
030204 cardiovascular system & hematology
Effective Regurgitant Orifice Area
Severity of Illness Index
Right atrial
030218 nuclear medicine & medical imaging
Hypoplastic left heart syndrome
03 medical and health sciences
0302 clinical medicine
Internal medicine
Hypoplastic Left Heart Syndrome
Humans
Medicine
Radiology, Nuclear Medicine and imaging
Vena contracta
business.industry
Mitral Valve Insufficiency
Reproducibility of Results
Color doppler
medicine.disease
Tricuspid Valve Insufficiency
Echocardiography, Doppler, Color
Cardiology
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 08947317
- Volume :
- 34
- Database :
- OpenAIRE
- Journal :
- Journal of the American Society of Echocardiography
- Accession number :
- edsair.doi.dedup.....7fb6176c6b35eff66ebfb8c3a0f26711
- Full Text :
- https://doi.org/10.1016/j.echo.2021.03.004