Echocardiography versus Magnetic Resonance Imaging Quantification and Novel Algorithm for Isolated Severe Tricuspid Regurgitation
Transthoracic echocardiography (TTE) is the first-line tool to evaluate isolated tricuspid regurgitation (TR), but has limitations, and its TR quantification compared with magnetic resonance imaging (MRI) has been studied infrequently. We compared isolated severe TR quantification by TTE against MRI...
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| Veröffentlicht in: | The American journal of cardiology 2024-01, Vol.211, p.40-48 |
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| creator | Wang, Tom Kai-Ming Reyaldeen, Reza Akyuz, Kevser Popovic, Zoran B Gillinov, A Marc Xu, Bo Griffin, Brian P Desai, Milind Y |
| description | Transthoracic echocardiography (TTE) is the first-line tool to evaluate isolated tricuspid regurgitation (TR), but has limitations, and its TR quantification compared with magnetic resonance imaging (MRI) has been studied infrequently. We compared isolated severe TR quantification by TTE against MRI, and developed a novel TTE-based algorithm. Isolated TR patients graded severe by TTE and undergoing MRI 2007/01-2019/06 were studied. TTE and MRI measurements were analyzed by correlation, area under receiver-operative characteristics curve (AUC), and classification and regression tree algorithm of TTE parameters to best identify MRI-derived severe TR (regurgitant volume ≥45mL and/or fraction ≥50%). A total of 108/262 (41%) graded as severe TR by TTE also had severe TR by MRI. There were moderate correlations between TTE and MRI in quantification of TR severity and right atrial size (Pearson r=0.428-0.645), but none to modest correlations between them in right ventricle quantification. Key TTE parameters to identify MRI-derived severe TR in the decision tree regression algorithm were right atrial volume indexed ≥47 mL/m2, then effective regurgitant orifice area ≥0.45 cm2, and especially if right ventricle free wall strain ≥-9.5%. This novel algorithm has AUC 0.76 and 79% agreement to detect severe TR by MRI, higher than the American Society of Echocardiography criteria with AUC 0.68 and 66% agreement (P=0.006 and P |
| doi_str_mv | 10.1016/j.amjcard.2023.10.062 |
| format | Article |
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We compared isolated severe TR quantification by TTE against MRI, and developed a novel TTE-based algorithm. Isolated TR patients graded severe by TTE and undergoing MRI 2007/01-2019/06 were studied. TTE and MRI measurements were analyzed by correlation, area under receiver-operative characteristics curve (AUC), and classification and regression tree algorithm of TTE parameters to best identify MRI-derived severe TR (regurgitant volume ≥45mL and/or fraction ≥50%). A total of 108/262 (41%) graded as severe TR by TTE also had severe TR by MRI. There were moderate correlations between TTE and MRI in quantification of TR severity and right atrial size (Pearson r=0.428-0.645), but none to modest correlations between them in right ventricle quantification. Key TTE parameters to identify MRI-derived severe TR in the decision tree regression algorithm were right atrial volume indexed ≥47 mL/m2, then effective regurgitant orifice area ≥0.45 cm2, and especially if right ventricle free wall strain ≥-9.5%. This novel algorithm has AUC 0.76 and 79% agreement to detect severe TR by MRI, higher than the American Society of Echocardiography criteria with AUC 0.68 and 66% agreement (P=0.006 and P<0.001 respectively). In conclusion, TTE-derived TR and right atrial quantification had moderate correlation and discrimination of severe TR by MRI, from which a novel TTE algorithm was derived, which had incrementally higher accuracy than contemporary guidelines’ criteria alone.</description><identifier>ISSN: 0002-9149</identifier><identifier>ISSN: 1879-1913</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2023.10.062</identifier><identifier>PMID: 37890567</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Algorithms ; Cardiac arrhythmia ; Correlation ; Criteria ; Decision trees ; Echocardiography ; Echocardiography - methods ; Ejection fraction ; Heart Ventricles ; Humans ; Magnetic Resonance Imaging ; Medical imaging ; Medical prognosis ; Orifices ; Parameter identification ; Regression analysis ; Regurgitation ; Surgery ; tricuspid regurgitation ; tricuspid valve ; Tricuspid Valve Insufficiency - diagnostic imaging ; Ventricle</subject><ispartof>The American journal of cardiology, 2024-01, Vol.211, p.40-48</ispartof><rights>2023</rights><rights>Copyright © 2023 Elsevier Inc. All rights reserved.</rights><rights>2023. Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c393t-63f4c1204eea2b4cb711f85d23e00a52bb5934bbd70fd11e8088e63097f7da2f3</citedby><cites>FETCH-LOGICAL-c393t-63f4c1204eea2b4cb711f85d23e00a52bb5934bbd70fd11e8088e63097f7da2f3</cites><orcidid>0000-0003-0010-9797 ; 0000-0001-5570-9402</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2909641887?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3541,27915,27916,45986,64374,64376,64378,72230</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37890567$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wang, Tom Kai-Ming</creatorcontrib><creatorcontrib>Reyaldeen, Reza</creatorcontrib><creatorcontrib>Akyuz, Kevser</creatorcontrib><creatorcontrib>Popovic, Zoran B</creatorcontrib><creatorcontrib>Gillinov, A Marc</creatorcontrib><creatorcontrib>Xu, Bo</creatorcontrib><creatorcontrib>Griffin, Brian P</creatorcontrib><creatorcontrib>Desai, Milind Y</creatorcontrib><title>Echocardiography versus Magnetic Resonance Imaging Quantification and Novel Algorithm for Isolated Severe Tricuspid Regurgitation</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>Transthoracic echocardiography (TTE) is the first-line tool to evaluate isolated tricuspid regurgitation (TR), but has limitations, and its TR quantification compared with magnetic resonance imaging (MRI) has been studied infrequently. We compared isolated severe TR quantification by TTE against MRI, and developed a novel TTE-based algorithm. Isolated TR patients graded severe by TTE and undergoing MRI 2007/01-2019/06 were studied. TTE and MRI measurements were analyzed by correlation, area under receiver-operative characteristics curve (AUC), and classification and regression tree algorithm of TTE parameters to best identify MRI-derived severe TR (regurgitant volume ≥45mL and/or fraction ≥50%). A total of 108/262 (41%) graded as severe TR by TTE also had severe TR by MRI. There were moderate correlations between TTE and MRI in quantification of TR severity and right atrial size (Pearson r=0.428-0.645), but none to modest correlations between them in right ventricle quantification. Key TTE parameters to identify MRI-derived severe TR in the decision tree regression algorithm were right atrial volume indexed ≥47 mL/m2, then effective regurgitant orifice area ≥0.45 cm2, and especially if right ventricle free wall strain ≥-9.5%. This novel algorithm has AUC 0.76 and 79% agreement to detect severe TR by MRI, higher than the American Society of Echocardiography criteria with AUC 0.68 and 66% agreement (P=0.006 and P<0.001 respectively). In conclusion, TTE-derived TR and right atrial quantification had moderate correlation and discrimination of severe TR by MRI, from which a novel TTE algorithm was derived, which had incrementally higher accuracy than contemporary guidelines’ criteria alone.</description><subject>Algorithms</subject><subject>Cardiac arrhythmia</subject><subject>Correlation</subject><subject>Criteria</subject><subject>Decision trees</subject><subject>Echocardiography</subject><subject>Echocardiography - methods</subject><subject>Ejection fraction</subject><subject>Heart Ventricles</subject><subject>Humans</subject><subject>Magnetic Resonance Imaging</subject><subject>Medical imaging</subject><subject>Medical prognosis</subject><subject>Orifices</subject><subject>Parameter identification</subject><subject>Regression analysis</subject><subject>Regurgitation</subject><subject>Surgery</subject><subject>tricuspid regurgitation</subject><subject>tricuspid valve</subject><subject>Tricuspid Valve Insufficiency - diagnostic imaging</subject><subject>Ventricle</subject><issn>0002-9149</issn><issn>1879-1913</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkc1u1DAUhS0EokPhEUCW2HSTwT9xYq9QVRUYqT8Cytpy7JuMoyQe7GSkLvvmeJiBBRtWlq--c3zlD6G3lKwpodWHfm3G3pro1owwnmdrUrFnaEVlrQqqKH-OVoQQVihaqjP0KqU-XykV1Ut0xmupiKjqFXq6tttwqPGhi2a3fcR7iGlJ-NZ0E8ze4m-QwmQmC3gzms5PHf66mGn2rbdm9mHCZnL4LuxhwJdDF6KftyNuQ8SbFAYzg8PfIXcCfojeLmnnXa7sltj5-Xf-NXrRmiHBm9N5jn58un64-lLc3H_eXF3eFJYrPhcVb0tLGSkBDGtK29SUtlI4xoEQI1jTCMXLpnE1aR2lIImUUHGi6rZ2hrX8HF0ce3cx_FwgzXr0ycIwmAnCkjSTkgsphCgz-v4ftA9LnPJ2mimiqpJKWWdKHCkbQ0oRWr2LfjTxUVOiD450r0-O9MHRYZwd5dy7U_vSjOD-pv5IycDHIwD5O_Yeok7WQzbgfAQ7axf8f574BTUGpzY</recordid><startdate>20240115</startdate><enddate>20240115</enddate><creator>Wang, Tom Kai-Ming</creator><creator>Reyaldeen, Reza</creator><creator>Akyuz, Kevser</creator><creator>Popovic, Zoran B</creator><creator>Gillinov, A Marc</creator><creator>Xu, Bo</creator><creator>Griffin, Brian P</creator><creator>Desai, Milind Y</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M7Z</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0010-9797</orcidid><orcidid>https://orcid.org/0000-0001-5570-9402</orcidid></search><sort><creationdate>20240115</creationdate><title>Echocardiography versus Magnetic Resonance Imaging Quantification and Novel Algorithm for Isolated Severe Tricuspid Regurgitation</title><author>Wang, Tom Kai-Ming ; 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We compared isolated severe TR quantification by TTE against MRI, and developed a novel TTE-based algorithm. Isolated TR patients graded severe by TTE and undergoing MRI 2007/01-2019/06 were studied. TTE and MRI measurements were analyzed by correlation, area under receiver-operative characteristics curve (AUC), and classification and regression tree algorithm of TTE parameters to best identify MRI-derived severe TR (regurgitant volume ≥45mL and/or fraction ≥50%). A total of 108/262 (41%) graded as severe TR by TTE also had severe TR by MRI. There were moderate correlations between TTE and MRI in quantification of TR severity and right atrial size (Pearson r=0.428-0.645), but none to modest correlations between them in right ventricle quantification. Key TTE parameters to identify MRI-derived severe TR in the decision tree regression algorithm were right atrial volume indexed ≥47 mL/m2, then effective regurgitant orifice area ≥0.45 cm2, and especially if right ventricle free wall strain ≥-9.5%. This novel algorithm has AUC 0.76 and 79% agreement to detect severe TR by MRI, higher than the American Society of Echocardiography criteria with AUC 0.68 and 66% agreement (P=0.006 and P<0.001 respectively). In conclusion, TTE-derived TR and right atrial quantification had moderate correlation and discrimination of severe TR by MRI, from which a novel TTE algorithm was derived, which had incrementally higher accuracy than contemporary guidelines’ criteria alone.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>37890567</pmid><doi>10.1016/j.amjcard.2023.10.062</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-0010-9797</orcidid><orcidid>https://orcid.org/0000-0001-5570-9402</orcidid></addata></record> |
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| subjects | Algorithms Cardiac arrhythmia Correlation Criteria Decision trees Echocardiography Echocardiography - methods Ejection fraction Heart Ventricles Humans Magnetic Resonance Imaging Medical imaging Medical prognosis Orifices Parameter identification Regression analysis Regurgitation Surgery tricuspid regurgitation tricuspid valve Tricuspid Valve Insufficiency - diagnostic imaging Ventricle |
| title | Echocardiography versus Magnetic Resonance Imaging Quantification and Novel Algorithm for Isolated Severe Tricuspid Regurgitation |
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