Three-Dimensional Transthoracic Echocardiographic Evaluation of Tricuspid Regurgitation Severity using Vena Contracta Area in Comparison with Volumetric Method

Background: In clinical practice, tricuspid regurgitation (TR) is a valvular heart requirement that is frequent. Aim of the work: The objective is to utilize the 2D-determined EROA volumetric approach as a reference to establish 3D vena contracta area Cutoff values and ranges for (VCA) to differentiate TR grades, exceptionally mild and severe TR. Furthermore, to provide a standard calibration for TR grading, compare colour Doppler 2D regurgitant orifice area (ROA) and 3D VCA. Patients and methods: This study was done at the Cardiology Department of Al-Azhar University (Bab El-Sheriaa University Hospital) from February 2023 to October 2023. It included fifty consecutive patients; 31 patients had severe TR, and the other 19 had moderate TR. Results: As regards the 3D Echo-Doppler study Vena contract, the mean was (89.4 ± 38.5) mm2 with minimum 54 mm2 and maximum 300 mm2, also 3D Echo Doppler study Vena contract can be used to discriminate between patients with moderate and severe TR at a cutoff level of > 76 mm2, with 96.8% sensitivity, 89.5% specificity, PPV of 93.7 per cent and NPV of 94.4 per cent (AUC = 0.924 & p-value <0.001). Moreover, there was a High statistically significant (p <0.001) increase in the 3D ECHO study Vena contracta in patients with severe TR (median= 92, IQR 81-100) than in patients with moderate TR (median= 69, IQR 58-74). Conclusion: A practical and reliable indicator of TR severity is the 3D measurement of VC area. Another way to assess the degree of regurgitant regurgitation is to evaluate the VCA of a TR utilizing 3D colour Doppler echocardiography. When determining the severity of a TR, Three-dimensional direct planimetry from VCA is a dependable method that can be used in clinical settings.