[Quantification of tricuspid insufficiency--comparison of Doppler echocardiography and radionuclide ventriculography].
In 40 patients (pts) (ages 34-83 years) the severity of tricuspid regurgitation (TR) was graded by pulsed Doppler echocardiographic determination of regurgitant jet extension. Mild TR was assessed in seven pts (group I), mode-rate TR in 20 pts (group II), and severe TR in 13 pts (group III). The enddiastolic diameter of the left ventricle as measured by M-mode-echocardiography was 55 +/- 16 mm in group I, 48 +/- 6 mm in group II, and 50 +/- 10 mm in group III. The regurgitant index (RI), i.e., the ratio of left-to-right-ventricular stroke counts (normal range 0.89-1.97) and the time-activity curve over the liver area were measured by equilibrium radionuclide ventriculography (RNV). The RI differed significantly between group I (1.6 +/- 0.5), II (1.0 +/- 0.3), and III (0.8 +/- 0.3) (p less than 0.01). An RI-value below 0.89 as an index of right-ventricular volume overload was found in 14% (group I), 45%, (group II) and 77% (group III). The time-activity curve over the liver area, as graded by count variation in phase with the right atrium from 1 (no count variation) to 4 (typical count variation) showed all grades in groups I and II, but only grade 2 to 4 in group III. The RI resp. the time-activity curve over the liver is a sensitive parameter for the detection of moderate to severe TR. If TR is ascertained, severe regurgitation can be differentiated from mild regurgitation by RNV-derived RI as an index of right-ventricular volume overload.
Grossmann
G
G
Abteilung Innere Medizin IV, Medizinische Klinik Universität Ulm.
Otto
L
L
Felder
C
C
Clausen
M
M
Kress
P
P
Schmidt
A
A
Henze
E
E
Hombach
V
V
D000328:Adult; D000368:Aged; D002302:Cardiac Output / Q000502:physiology; D015150:Echocardiography, Doppler; D005260:Female; D006350:Heart Valve Prosthesis; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000503:physiopathology; D015635:Radionuclide Ventriculography; D013599:Systole / Q000502:physiology; D014261:Tricuspid Valve / Q000503:physiopathology; D014262:Tricuspid Valve Insufficiency / Q000175:diagnosis* / Q000503:physiopathology
Schweregradbestimmung der Trikuspidalinsuffizienz--Vergleich von Dopplerechokardiographie und Radionuklidventrikulographie.