Comparison of the echocardiographic and hemodynamic diagnosis of rheumatic tricuspid stenosis

David E. Guyer, Linda Gillam, Rodney A. Foale, Mary C. Clark, Robert Dinsmore, Igor Palacios, Peter Block, Mary Etta King, Arthur E. Weyman

Research output: Contribution to journalArticle

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Abstract

Two-dimensional echocardiography has proved to be reliable in the diagnosis of mitral, aortic and pulmonary stenosis. Its role in the diagnosis of rheumatic tricuspid stenosis is still being defined; therefore, the tricuspid valve echograms of 147 patients with rheumatic heart disease were examined. Thirty-eight of these patients also underwent hemodynamic evaluation. Tricuspid stenosis was defined echocardiographically as diastolic anterior leaflet doming, thickening and restricted excursion of the other two tricuspid leaflets and decreased separation of the leaflet tips. Using these criteria, the sensitivity and specificity of the echocardiogram In detecting tricuspid stenosis were 69 and 96%, respectively, in the group of 38 patients who had both echocardiographic and hemodynamic evaluations. However, when the smaller group of 17 patients who had simultaneous right atrial and right ventricular pressure recordings were considered separately, there was complete agreement between the echocardiographic and hemodynamic data. Thus, the two-dimensional echocardiogram is a sensitive and specific test for diagnosing rheumatic tricuspid stenosis. In addition, these data provided an opportunity to determine the prevalence of tricuspid stenosis in this group of patients with chronic rheumatic valvular disease. Tricuspid stenosis was present in 14 (9.5%) of the total group of 147 patients who had two-dimensional echocardiograms, and in 10 (26.3%) of the 38 who had both echocardiographic and hemodynamic studies. In patients with rheumatic heart disease about to undergo cardiac catheterization, an echocardiographic study should prove useful in making the diagnosis of tricuspid stenosis.

Original languageEnglish (US)
Pages (from-to)1135-1144
Number of pages10
JournalJournal of the American College of Cardiology
Volume3
Issue number5
DOIs
StatePublished - Jan 1 1984

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Pathologic Constriction
Hemodynamics
Rheumatic Heart Disease
Pulmonary Valve Stenosis
Tricuspid Valve
Mitral Valve Stenosis
Aortic Valve Stenosis
Ventricular Pressure
Cardiac Catheterization
Rheumatic Diseases
Echocardiography
Sensitivity and Specificity

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Guyer, David E. ; Gillam, Linda ; Foale, Rodney A. ; Clark, Mary C. ; Dinsmore, Robert ; Palacios, Igor ; Block, Peter ; King, Mary Etta ; Weyman, Arthur E. / Comparison of the echocardiographic and hemodynamic diagnosis of rheumatic tricuspid stenosis. In: Journal of the American College of Cardiology. 1984 ; Vol. 3, No. 5. pp. 1135-1144.
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abstract = "Two-dimensional echocardiography has proved to be reliable in the diagnosis of mitral, aortic and pulmonary stenosis. Its role in the diagnosis of rheumatic tricuspid stenosis is still being defined; therefore, the tricuspid valve echograms of 147 patients with rheumatic heart disease were examined. Thirty-eight of these patients also underwent hemodynamic evaluation. Tricuspid stenosis was defined echocardiographically as diastolic anterior leaflet doming, thickening and restricted excursion of the other two tricuspid leaflets and decreased separation of the leaflet tips. Using these criteria, the sensitivity and specificity of the echocardiogram In detecting tricuspid stenosis were 69 and 96{\%}, respectively, in the group of 38 patients who had both echocardiographic and hemodynamic evaluations. However, when the smaller group of 17 patients who had simultaneous right atrial and right ventricular pressure recordings were considered separately, there was complete agreement between the echocardiographic and hemodynamic data. Thus, the two-dimensional echocardiogram is a sensitive and specific test for diagnosing rheumatic tricuspid stenosis. In addition, these data provided an opportunity to determine the prevalence of tricuspid stenosis in this group of patients with chronic rheumatic valvular disease. Tricuspid stenosis was present in 14 (9.5{\%}) of the total group of 147 patients who had two-dimensional echocardiograms, and in 10 (26.3{\%}) of the 38 who had both echocardiographic and hemodynamic studies. In patients with rheumatic heart disease about to undergo cardiac catheterization, an echocardiographic study should prove useful in making the diagnosis of tricuspid stenosis.",
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Guyer, DE, Gillam, L, Foale, RA, Clark, MC, Dinsmore, R, Palacios, I, Block, P, King, ME & Weyman, AE 1984, 'Comparison of the echocardiographic and hemodynamic diagnosis of rheumatic tricuspid stenosis', Journal of the American College of Cardiology, vol. 3, no. 5, pp. 1135-1144. https://doi.org/10.1016/S0735-1097(84)80170-9

Comparison of the echocardiographic and hemodynamic diagnosis of rheumatic tricuspid stenosis. / Guyer, David E.; Gillam, Linda; Foale, Rodney A.; Clark, Mary C.; Dinsmore, Robert; Palacios, Igor; Block, Peter; King, Mary Etta; Weyman, Arthur E.

In: Journal of the American College of Cardiology, Vol. 3, No. 5, 01.01.1984, p. 1135-1144.

Research output: Contribution to journalArticle

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AU - Gillam, Linda

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