Noninvasive Evaluation of Rheumatic Tricuspid Stenosis with Doppler and 2 Dimensional Echocardiography

Shin, Yung Woo

Abstract

In order to determine the meaning of tricuspid stenosis(TS) in rhematic valvular heart disease(RVHD), 310 consecutive patients with RVHD were assessed by Doppler and 2-dimensional(2D) echocardiography. The frequency of 2D echocardiographic TS(diastolic doming of anterior tricuspid leaflet and thickened tricuspid leaflets) was 8.4%, and all patients with 2D echocardiographic TS had the mean tricuspid pressure gradient(MTPG) of 1mmHg or more compared to normal control of less than 1mmHg with Doppler echocardiography. The frequency of clinically significant hemodynamic TS(MTPG>2mmHg) and of servere hemodynamic TS(MTPG>5mmHg) in RVHD were 3.5% and 0.6% respectively. Rheumatic TS was accompanied by tricuspid regurgitation in the frequency of 92.3% and did not occurs in pure mitral regurgitation. Rhematic TS occurs with high frequency in advanced rheumatic valvular stenosis, and the frequency of rheumatic TS in severe rheumatic mitral stenosis and mitral stenosis coexing with aortic stenosis were 20.8% and 23.9% respectively. The results indicates that TS in RVHD is little practical meaning but is unable to disregard especially in the cases of advanced rhematic valvular stenosis, and there is need to recognize of TS in RVHD.