Echocardiographic and laboratory parameters associated with progression of tricuspid valve regurgitation

Abstract

Introduction Even though tricuspid valve regurgitation (TR) is a frequent echocardiographic finding in heart failure, the significance of TR to in acute settings is not well studied. Purpose To investigate the relationship between echocardiographic and laboratory markers of TR severity in acute dyspnoea patients. Methods Echocardiography was performed in 482 patients with acute dyspnoea in prospective multicentre observational study during the first 48 hours after presentation to the emergency department. Echocardiographic quantification included the following parameters: tricuspid annular plane systolic excursion (TAPSE), velocity of the tricuspid annular systolic motion (RV S’), RV fractional area change (FAC), RV basal diameter, entire RV strain, strain of free RV wall, inferior vena cava (IVC) and left atrium (LA) parameters. The current study included 347 patients with full sets of parameters. Patients were divided into groups according to TR severity, as qualitatively assessed by Doppler echocardiography: mild - I’ and I’-II’ regurgitation; moderate – II’ and II’-III’; severe – III’ or greater. Data were analysed using One-way ANOVA. Results The distribution of echocardiography and laboratory parameters among the TR groups is shown in Table 1. Conclusions The progression of tricuspid regurgitation is proportional to right heart remodelling as well as right and left ventricular dysfunction. Mild TR N=187 (54%) Moderate TR N=105 (30%) Severe TR N=55 (16%) TAPSE (cm) 1.7±0.5 1.5±0.5* 1.4±0.5* RV FAC (%) 36.3±13.2 36.1±14.5 31.8±11.6 RV S’ (cm/s) 10.4±2.8 9.6±2.8 8.8±3.4* RV basal diameter (cm) 4.3±0.8 4.7±1.0* 5.0±1.1* RA area (cm2) 23.2±7.3 26.7±9.4* 30.4±9.8* Strain of RV free wall (%) -16.9±6.6 -15.8±6.1 -14.2±4.2 Strain of entire RV (%) -13.0±5.3 -12.1±4.6 -10.9±3.6 IVC expiration (cm) 2.2±0.5 2.4±0.5* 2.6±0.7* IVC inspiration (cm) 1.3±0.7 1.6±0.8* 1.9±0.[...].