Alexandra S Buta, Luigi P Badano, Marco Penso, Michele Tomaselli, Yuka Kawada, Noela D Radu, Alexandra Clement, Paolo Springhetti, Samantha Fisicaro, Francesca Heilbron, Giorgia Benzoni, Cinzia Pece, Francesco Damiani, Federico Franciosi, Bogdan A Popescu, Denisa Muraru
{"title":"用新的校正近端等速表面积阈值改进三尖瓣反流严重程度评估。","authors":"Alexandra S Buta, Luigi P Badano, Marco Penso, Michele Tomaselli, Yuka Kawada, Noela D Radu, Alexandra Clement, Paolo Springhetti, Samantha Fisicaro, Francesca Heilbron, Giorgia Benzoni, Cinzia Pece, Francesco Damiani, Federico Franciosi, Bogdan A Popescu, Denisa Muraru","doi":"10.1093/ehjci/jeaf288","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims: </strong>Research has shown that the corrected proximal isovelocity surface area (PISA) method yields larger values for regurgitant volume (RegVol) and effective regurgitant orifice area (EROA) than conventional PISA method. However, it remains unclear whether new threshold values are needed for the corrected PISA method to effectively categorize the severity of secondary tricuspid regurgitation (STR). This study sought to identify threshold values for EROA and RegVol measured by the corrected PISA method for a three-grade classification of STR severity.</p><p><strong>Methods and results: </strong>We used three-dimensional echocardiography to determine the volumetric regurgitant fraction (RegFr), calculated as the difference between the right (RV) and left ventricular (LV) stroke volumes (SV) divided by the RVSV. A total of 213 patients (78±10 years; 64% women) with isolated STR were enrolled. Based on RegFr, we classified STR severity into mild (RegFr< 16%), moderate (RegFr 16-49%), and severe (RegFr> 49%) grades. EROA and RegVol were measured using conventional (EROACONV, RegVolCONV) and corrected (EROACORR, RegVolCORR) PISA methods.The threshold values for identifying patients with mild, moderate, and severe STR were <0.22 cm², 0.22-0.46 cm², and >0.46 cm² for EROACORR, respectively; and <18 mL, 18-42 mL, and >42 mL for RegVolCORR, respectively. The accuracy of these new threshold values in predicting STR severity based on RegFr was 99% for EROACORR and 94% for RegVolCORR. These accuracies were significantly higher than those of EROACONV (90%, p<0.001) and RegVolCONV (41%, p<0.001).</p><p><strong>Conclusion: </strong>New threshold values for the corrected PISA method must be considered to improve the classification of STR severity.</p>","PeriodicalId":12026,"journal":{"name":"European Heart Journal - Cardiovascular Imaging","volume":" ","pages":""},"PeriodicalIF":6.6000,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Refining tricuspid regurgitation severity assessment with new corrected proximal isovelocity surface area threshold values.\",\"authors\":\"Alexandra S Buta, Luigi P Badano, Marco Penso, Michele Tomaselli, Yuka Kawada, Noela D Radu, Alexandra Clement, Paolo Springhetti, Samantha Fisicaro, Francesca Heilbron, Giorgia Benzoni, Cinzia Pece, Francesco Damiani, Federico Franciosi, Bogdan A Popescu, Denisa Muraru\",\"doi\":\"10.1093/ehjci/jeaf288\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aims: </strong>Research has shown that the corrected proximal isovelocity surface area (PISA) method yields larger values for regurgitant volume (RegVol) and effective regurgitant orifice area (EROA) than conventional PISA method. However, it remains unclear whether new threshold values are needed for the corrected PISA method to effectively categorize the severity of secondary tricuspid regurgitation (STR). This study sought to identify threshold values for EROA and RegVol measured by the corrected PISA method for a three-grade classification of STR severity.</p><p><strong>Methods and results: </strong>We used three-dimensional echocardiography to determine the volumetric regurgitant fraction (RegFr), calculated as the difference between the right (RV) and left ventricular (LV) stroke volumes (SV) divided by the RVSV. A total of 213 patients (78±10 years; 64% women) with isolated STR were enrolled. Based on RegFr, we classified STR severity into mild (RegFr< 16%), moderate (RegFr 16-49%), and severe (RegFr> 49%) grades. EROA and RegVol were measured using conventional (EROACONV, RegVolCONV) and corrected (EROACORR, RegVolCORR) PISA methods.The threshold values for identifying patients with mild, moderate, and severe STR were <0.22 cm², 0.22-0.46 cm², and >0.46 cm² for EROACORR, respectively; and <18 mL, 18-42 mL, and >42 mL for RegVolCORR, respectively. The accuracy of these new threshold values in predicting STR severity based on RegFr was 99% for EROACORR and 94% for RegVolCORR. These accuracies were significantly higher than those of EROACONV (90%, p<0.001) and RegVolCONV (41%, p<0.001).</p><p><strong>Conclusion: </strong>New threshold values for the corrected PISA method must be considered to improve the classification of STR severity.</p>\",\"PeriodicalId\":12026,\"journal\":{\"name\":\"European Heart Journal - Cardiovascular Imaging\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":6.6000,\"publicationDate\":\"2025-10-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Heart Journal - Cardiovascular Imaging\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/ehjci/jeaf288\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Heart Journal - Cardiovascular Imaging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/ehjci/jeaf288","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Refining tricuspid regurgitation severity assessment with new corrected proximal isovelocity surface area threshold values.
Aims: Research has shown that the corrected proximal isovelocity surface area (PISA) method yields larger values for regurgitant volume (RegVol) and effective regurgitant orifice area (EROA) than conventional PISA method. However, it remains unclear whether new threshold values are needed for the corrected PISA method to effectively categorize the severity of secondary tricuspid regurgitation (STR). This study sought to identify threshold values for EROA and RegVol measured by the corrected PISA method for a three-grade classification of STR severity.
Methods and results: We used three-dimensional echocardiography to determine the volumetric regurgitant fraction (RegFr), calculated as the difference between the right (RV) and left ventricular (LV) stroke volumes (SV) divided by the RVSV. A total of 213 patients (78±10 years; 64% women) with isolated STR were enrolled. Based on RegFr, we classified STR severity into mild (RegFr< 16%), moderate (RegFr 16-49%), and severe (RegFr> 49%) grades. EROA and RegVol were measured using conventional (EROACONV, RegVolCONV) and corrected (EROACORR, RegVolCORR) PISA methods.The threshold values for identifying patients with mild, moderate, and severe STR were <0.22 cm², 0.22-0.46 cm², and >0.46 cm² for EROACORR, respectively; and <18 mL, 18-42 mL, and >42 mL for RegVolCORR, respectively. The accuracy of these new threshold values in predicting STR severity based on RegFr was 99% for EROACORR and 94% for RegVolCORR. These accuracies were significantly higher than those of EROACONV (90%, p<0.001) and RegVolCONV (41%, p<0.001).
Conclusion: New threshold values for the corrected PISA method must be considered to improve the classification of STR severity.
期刊介绍:
European Heart Journal – Cardiovascular Imaging is a monthly international peer reviewed journal dealing with Cardiovascular Imaging. It is an official publication of the European Association of Cardiovascular Imaging, a branch of the European Society of Cardiology.
The journal aims to publish the highest quality material, both scientific and clinical from all areas of cardiovascular imaging including echocardiography, magnetic resonance, computed tomography, nuclear and invasive imaging. A range of article types will be considered, including original research, reviews, editorials, image focus, letters and recommendation papers from relevant groups of the European Society of Cardiology. In addition it provides a forum for the exchange of information on all aspects of cardiovascular imaging.