Abstract:
Tricuspid regurgitation (TR) is a prevalent valvular disease with a significant mortality rate. The evaluation of TR severity and associated right heart remodeling and dysfunction is crucial to determine the optimal therapeutic strategy and to improve prognosis. While echocardiography remains the first-line imaging technique to evaluate TR, it has many limitations, both operator- and patient-related. Cardiovascular magnetic resonance imaging (CMR) has emerged as an innovative and comprehensive non-invasive cardiac imaging technique with additional value beyond routine echocardiographic assessment. Besides its established role as the gold standard for the evaluation of cardiac volumes, CMR can add important insights with regard to valvular anatomy and function. Accurate quantification of TR severity, including calculation of regurgitant volume and fraction, can be performed using either the well-known indirect volumetric method or novel 4D flow imaging. In addition, CMR can be used to assess the impact on the right heart, including right heart remodeling, function and tissue characterization. Several CMR-derived parameters have been associated with outcome, highlighting the importance of multi-modality imaging in patients with TR. The aim of this review is to provide an overview of the current role of CMR in the assessment and management of patients with TR and its future applications.
摘要:
三尖瓣返流(TR)是一种常见的瓣膜疾病,死亡率高。评估TR严重程度以及相关的右心重塑和功能障碍对于确定最佳治疗策略和改善预后至关重要。虽然超声心动图仍然是评估TR的一线成像技术,它有很多限制,与手术和患者有关。心血管磁共振成像(CMR)已成为一种创新且全面的非侵入性心脏成像技术,具有超出常规超声心动图评估的附加价值。除了其作为评估心脏体积的黄金标准的既定作用,CMR可以增加关于瓣膜解剖结构和功能的重要见解。TR严重程度的准确量化,包括反流体积和分数的计算,可以使用众所周知的间接体积方法或新颖的4D流成像来执行。此外,CMR可用于评估对右心的影响,包括右心重塑,功能和组织表征。几个CMR衍生参数与结果相关,强调多模态成像在TR患者中的重要性。这篇综述的目的是概述CMR在TR患者评估和管理中的当前作用及其未来应用。