Abstract
Background: Our purpose was to test the following hypotheses: (1) patients with hypoplastic left heart syndrome who develop significant tricuspid regurgitation (TR) or require tricuspid valve (TV) surgery in the medium term have detectable TV abnormalities by 3-dimensional echocardiography (3DE) prestage 1 palliation and (2) TR is associated with reduced survival and increased TV intervention. Methods and Results: Infants were prospectively studied with 3DE and 2DE prestage 1 and followed up for the end points of TR, TV surgery, transplantation, or death. From prestage 1 3DE, spatial coordinates of TV annulus and leaflets were extracted; annulus size, leaflet area, prolapse volume, tethering volume, bending angle, and papillary muscle angle were measured. TR was assessed prestage 1 and at latest follow-up. Of 70 patients, 62 (88.6%) had mild or less TR and 8 (11.4%) had moderate or greater TR prestage 1. Prestage 1 tethering volume correlated to leaflet area (r=0.736; P<0.001), annulus area (r=0.651; P<0.001), right ventricular end-diastolic area (r=0.347; P=0.003), fractional area change (r=-0.387; P<0.001), and TR grade (r=0.447; P<0.001). At follow-up, 46 (65.7%) had mild or less TR (group A) and 24 (34.3%) had moderate or greater TR (group B). Prestage 1 3DE showed greater TV tethering volume and flatter annulus in group B. Survival was better in group A. Conclusions: Increased TV tethering volume and flatter bending angle prestage 1 palliation is associated with TV failure at medium-term follow-up. Increased prestage 1 tethering is related to having larger TV annulus, larger leaflet area, larger right ventricular size, and reduced systolic function. TR progression results in increased TV intervention and decreased survival.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 765-772 |
| Number of pages | 8 |
| Journal | Circulation: Cardiovascular Imaging |
| Volume | 7 |
| Issue number | 5 |
| DOIs | |
| State | Published - Sep 1 2014 |
| Externally published | Yes |
Fingerprint
Keywords
- Echocardiography
- Heart ventricles
- Hypoplastic left heart syndrome
- Pediatric cardiology
- Three-dimensional
- Tricuspid valve
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
- Cardiology and Cardiovascular Medicine
Cite this
Tricuspid regurgitation in hypoplastic left heart syndrome mechanistic insights from 3-dimensional echocardiography and relationship with outcomes. / Kutty, Shelby; Colen, Timothy; Thompson, Richard B.; Tham, Edythe; Li, Ling; Vijarnsorn, Chodchanok; Polak, Amanda; Truong, Dongngan T.; Danford, David A.; Smallhorn, Jeffrey F.; Khoo, Nee Scze.
In: Circulation: Cardiovascular Imaging, Vol. 7, No. 5, 01.09.2014, p. 765-772.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Tricuspid regurgitation in hypoplastic left heart syndrome mechanistic insights from 3-dimensional echocardiography and relationship with outcomes
AU - Kutty, Shelby
AU - Colen, Timothy
AU - Thompson, Richard B.
AU - Tham, Edythe
AU - Li, Ling
AU - Vijarnsorn, Chodchanok
AU - Polak, Amanda
AU - Truong, Dongngan T.
AU - Danford, David A.
AU - Smallhorn, Jeffrey F.
AU - Khoo, Nee Scze
PY - 2014/9/1
Y1 - 2014/9/1
N2 - Background: Our purpose was to test the following hypotheses: (1) patients with hypoplastic left heart syndrome who develop significant tricuspid regurgitation (TR) or require tricuspid valve (TV) surgery in the medium term have detectable TV abnormalities by 3-dimensional echocardiography (3DE) prestage 1 palliation and (2) TR is associated with reduced survival and increased TV intervention. Methods and Results: Infants were prospectively studied with 3DE and 2DE prestage 1 and followed up for the end points of TR, TV surgery, transplantation, or death. From prestage 1 3DE, spatial coordinates of TV annulus and leaflets were extracted; annulus size, leaflet area, prolapse volume, tethering volume, bending angle, and papillary muscle angle were measured. TR was assessed prestage 1 and at latest follow-up. Of 70 patients, 62 (88.6%) had mild or less TR and 8 (11.4%) had moderate or greater TR prestage 1. Prestage 1 tethering volume correlated to leaflet area (r=0.736; P<0.001), annulus area (r=0.651; P<0.001), right ventricular end-diastolic area (r=0.347; P=0.003), fractional area change (r=-0.387; P<0.001), and TR grade (r=0.447; P<0.001). At follow-up, 46 (65.7%) had mild or less TR (group A) and 24 (34.3%) had moderate or greater TR (group B). Prestage 1 3DE showed greater TV tethering volume and flatter annulus in group B. Survival was better in group A. Conclusions: Increased TV tethering volume and flatter bending angle prestage 1 palliation is associated with TV failure at medium-term follow-up. Increased prestage 1 tethering is related to having larger TV annulus, larger leaflet area, larger right ventricular size, and reduced systolic function. TR progression results in increased TV intervention and decreased survival.
AB - Background: Our purpose was to test the following hypotheses: (1) patients with hypoplastic left heart syndrome who develop significant tricuspid regurgitation (TR) or require tricuspid valve (TV) surgery in the medium term have detectable TV abnormalities by 3-dimensional echocardiography (3DE) prestage 1 palliation and (2) TR is associated with reduced survival and increased TV intervention. Methods and Results: Infants were prospectively studied with 3DE and 2DE prestage 1 and followed up for the end points of TR, TV surgery, transplantation, or death. From prestage 1 3DE, spatial coordinates of TV annulus and leaflets were extracted; annulus size, leaflet area, prolapse volume, tethering volume, bending angle, and papillary muscle angle were measured. TR was assessed prestage 1 and at latest follow-up. Of 70 patients, 62 (88.6%) had mild or less TR and 8 (11.4%) had moderate or greater TR prestage 1. Prestage 1 tethering volume correlated to leaflet area (r=0.736; P<0.001), annulus area (r=0.651; P<0.001), right ventricular end-diastolic area (r=0.347; P=0.003), fractional area change (r=-0.387; P<0.001), and TR grade (r=0.447; P<0.001). At follow-up, 46 (65.7%) had mild or less TR (group A) and 24 (34.3%) had moderate or greater TR (group B). Prestage 1 3DE showed greater TV tethering volume and flatter annulus in group B. Survival was better in group A. Conclusions: Increased TV tethering volume and flatter bending angle prestage 1 palliation is associated with TV failure at medium-term follow-up. Increased prestage 1 tethering is related to having larger TV annulus, larger leaflet area, larger right ventricular size, and reduced systolic function. TR progression results in increased TV intervention and decreased survival.
KW - Echocardiography
KW - Heart ventricles
KW - Hypoplastic left heart syndrome
KW - Pediatric cardiology
KW - Three-dimensional
KW - Tricuspid valve
UR - http://www.scopus.com/inward/record.url?scp=84964239608&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84964239608&partnerID=8YFLogxK
U2 - 10.1161/CIRCIMAGING.113.001161
DO - 10.1161/CIRCIMAGING.113.001161
M3 - Article
C2 - 25073974
AN - SCOPUS:84964239608
VL - 7
SP - 765
EP - 772
JO - Circulation: Cardiovascular Imaging
JF - Circulation: Cardiovascular Imaging
SN - 1941-9651
IS - 5
ER -