Accuracy of Doppler Echocardiography in Detecting and Quantifying Tricuspid Stenosis and Obstructed Tricuspid Prostheses

Abstract

Twenty patients (14 with native and 6 with prosthetic tricuspid valves) with tricuspid stenosis were studied by Doppler echocardiography, followed by cardiac catheterization within 24 h. The tricuspid mean diastolic pressure gradient (MDG) was calculated by the modified Bernoulli equation. Tricuspid valve area (TVA) was calculated by the pressure half-time (1/2 T) method. Data from Doppler echocardiography and cardiac catheterization were compared. The Doppler-derived tricuspid MDG was 1.9-13 (mean 5.8 ± 2.9) mm Hg which correlated moderately well with the catheterization-determined MDG of 2-17 (mean 7.3 ± 3.9) mm Hg, R = 0.65, standard error of the estimate (SEE) was 2.26 mm Hg, y = 0.48x + 2.27, p < 0.05. The Doppler-derived TVA using the equation 220/P 1/2T was 0.4-1.98 (mean 1.20 ± 0.45) cm^2, using the equation 190/P 1/2T it was 0.38-1.7 (mean 1.0 ± 0.38) cm^2, respectively, and had a good correlation with the catheterization-determined TVA of 0.3 -2.2 (mean 1.0 ± 0.48) cm^2, R = 0.82, SEE = 0.26 cm^2, y = 0.78x + 0.42, p < 0.001 and R = 0.82, SEE = 0.22, regression equation y = 0.66x + 0.37, p < 0.001, respectively. Of 14 patients undergoing right ventricular angiography, the angiographic and Doppler grades of tricuspid regurgitation matched exactly in 8, but were different by one grade in the remaining 6 patients. All 6 patients with an obstructed tricuspid prosthesis were correctly diagnosed by Doppler echocardiography. This study demonstrates that Doppler echocardiography is accurate in the diagnosis and quantification of tricuspid stenosis and obstructed tricuspid prostheses and compares well with cardiac catheterization.