Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 Summer;5(3):132-6.
Epub 2010 Aug 31.

Tricuspid regurgitation improvement in relation to the amount of pulmonary artery pressure reduction

Arezou Zoroufian  1 , Mohammad Sahebjam, Bahareh Eslami, Masoumeh Lotfi-Tokaldani, Mahmood Sheikhfathollahi, Seyed Ebrahim Kassaian
Affiliations

Tricuspid regurgitation improvement in relation to the amount of pulmonary artery pressure reduction

Arezou Zoroufian et al. J Tehran Heart Cent. 2010 Summer.

Abstract

Background: Given the common concomitance of tricuspid regurgitation (TR) with significant mitral stenosis, we aimed at exploring the relation between TR severity and pulmonary artery hypertension (PAH) in patients who underwent mitral balloon valvotomy (MBV).

Methods: We analyzed the echocardiography data of 133 consecutive patients (82.0% female, mean age 44.68 ± 12.56 years) with different degrees of TR severity that underwent MBV between April 2006 and March 2008. The pulmonary artery systolic pressure (PAPs) > 35 mmHg was considered as PAH.

Results: Before MBV, 36.20% of the patients had moderate to severe TR, 92.5% PAH, and 18.0% right ventricular (RV) dilation (RV dimension ≥ 33 mm). After MBV, TR severity improved in 41.4%, worsened in 8.3%, and did not change in 50.4%. Before and after MBV, PAPs was significantly correlated with TR severity, and the mean PAPs change in patients with improved TR was significantly more than that of patients without TR improvement (p value = 0.042). Tricuspid regurgitation severity and mean PAPs (from 52.83 ± 18.82 to 35.89 ± 9.39 mmHg) decreased significantly after MBV (both p values < 0.001); this reduction was significantly correlated to the amount of PAPs decrease. A cut-off point of ≥ 19 mmHg reduction in PAPs had a specificity of 71.79% and sensitivity of 52.73% to show TR severity improvement (by Receiver-Operative-Characteristics analysis). The mean of RV dimension decreased from 28.94 ± 5.43 to 27.95 ± 4.67 mm (p value < 0.001). In contrast to patients with RV dilation, TR reduced significantly in patients without RV dilation (p value < 0.001).

Conclusion: Improvement in TR severity was directly correlated with the amount of PAPs reduction after MBV. More studies are needed to better define a cut-off value for PAPs reduction related to TR severity improvement.

Keywords: Balloon dilatation; Pulmonary artery; Tricuspid valve insufficiency.

PubMed Disclaimer

References

    1. Otto CM, Bonow RO. Valvular heart disease. In: Libby P, Bonow RO, Mann DL, Zipes DP, editors. Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia: Elsevier Staunders; 2008. pp. 1625–1712.
    1. Groves P. Valve disease: surgery of valve disease: late results and late complications. Heart. 2001;86:715–721. - PMC - PubMed
    1. Sadeghi HM, Kimura BJ, Raisinghani A, Blanchard DG, Mahmud E, Fedullo PF, Jamieson SW, DeMaria AN. Does lowering pulmonary arterial pressure eliminate severe functional tricuspid regurgitation? Insights from pulmonary thromboendarterectomy. J Am Coll Cardiol. 2004;44:126–132. - PubMed
    1. Bernal JM, Gutierrez-Morlote J, Liorca J, San Jose JM, Morales D, Revuelta JM. Tricuspid vale repair: an old disease, a modern experience. Ann Thorac Surg. 2004;78:2069–2074. - PubMed
    1. Nath J, Foster E, Heidenreich PA. Impact of TR on long-term survival. J Am Coll Cardiol. 2004;43:405–409. - PubMed

LinkOut - more resources