The effect of pulmonary hypertension on ovine tricuspid annular dynamics

Malinowski, Marcin; Wilton, P.; Khaghani, Asghar; Langholz, David; Hooker, Victoria; Eberhart, Lenora; Hooker, Robert L.; Timek, Tomasz A.

doi:10.1093/ejcts/ezv052

Cited by 28 publications

(21 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Knio et al [ 17 ] used real-time 3D transesophageal echocardiography (TEE) to quantify the dimensions of the tricuspid annulus and analyze its geometric changes over the course of the cardiac cycle, and their analysis demonstrated that the tricuspid annulus is a nonplanar and dynamic structure. Malinowski et al [ 18 ] found the tricuspid annulus is a saddle-shaped nonplanar structure with 2 horns in the anteroseptal and posterior regions. During acute PH and LV pressure overload, the TA dilates along all annular regions while the 3D annular geometry is essentially preserved.…”

Section: Discussionmentioning

confidence: 99%

Tricuspid annular displacement measured by 2-dimensional speckle tracking echocardiography for predicting right ventricular function in pulmonary hypertension

Wang

Yang³

et al. 2018

Medicine

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Tricuspid annular displacement measured by 2-dimensional speckle tracking echocardiography for predicting right ventricular function in pulmonary hypertension

Wang

Yang³

et al. 2018

Medicine

View full text Add to dashboard Cite

show abstract

“…In the case of in-vivo studies of the TV annulus, measurements are generally made using MRI, 2DE/3DE, or CT (Figure 7a) [97,98]. A study by Hammarström et al (1991) [97] used 2DE to measure human annulus parameters with three primary observations: (i) an average annular diameter (between diastole and systole) of 22.5 mm, (ii) the greatest motion occurring along the lateral point of the TV annulus, and (iii) a hinge-point of the annulus movement occurring on the septal side.…”

Section: In-vivo and In-vitro Investigationsmentioning

confidence: 99%

“…These observations were later reaffirmed, and more details of the annulus movement were provided through other human in-vivo studies. For example, Ring et al (2012) [98] used 3DE to quantify: (i) AP and SL average diameters of 41.15 mm and 33.75 mm, respectively, (ii) heights from diastole to systole of 4.2 mm to 5.5 mm, respectively, (iii) areas from diastole to systole of 1145 mm 2 to 1049 mm 2 , respectively, (iv) perimeters from diastole to systole of 124 mm to 120 mm, respectively, and (v) eccentricity values from diastole to systole of 1.20 to 1.29, respectively. Regarding the annular movement, during diastole the annulus has a more circular shape, while during systole the annulus becomes more elliptical, as shown through the observed eccentricity values.…”

Section: In-vivo and In-vitro Investigationsmentioning

confidence: 99%

Mechanics of the Tricuspid Valve—From Clinical Diagnosis/Treatment, In-Vivo and In-Vitro Investigations, to Patient-Specific Biomechanical Modeling

et al. 2019

View full text Add to dashboard Cite

Proper tricuspid valve (TV) function is essential to unidirectional blood flow through the right side of the heart. Alterations to the tricuspid valvular components, such as the TV annulus, may lead to functional tricuspid regurgitation (FTR), where the valve is unable to prevent undesired backflow of blood from the right ventricle into the right atrium during systole. Various treatment options are currently available for FTR; however, research for the tricuspid heart valve, functional tricuspid regurgitation, and the relevant treatment methodologies are limited due to the pervasive expectation among cardiac surgeons and cardiologists that FTR will naturally regress after repair of left-sided heart valve lesions. Recent studies have focused on (i) understanding the function of the TV and the initiation or progression of FTR using both in-vivo and in-vitro methods, (ii) quantifying the biomechanical properties of the tricuspid valve apparatus as well as its surrounding heart tissue, and (iii) performing computational modeling of the TV to provide new insight into its biomechanical and physiological function. This review paper focuses on these advances and summarizes recent research relevant to the TV within the scope of FTR. Moreover, this review also provides future perspectives and extensions critical to enhancing the current understanding of the functioning and remodeling tricuspid valve in both the healthy and pathophysiological states.

show abstract

“…All data were recorded with Sonometrics Digital Ultrasonic Measurement System DS3 as previously reported [11]. Data from 3 consecutive heart cycles acquired at 128 Hz during sinus rhythm and steady-state haemodynamic conditions were merged to yield 3-dimensional co-ordinates of each sonomicrometry crystal for Baseline and each step of annular reduction.…”

Section: Data Acquisitionmentioning

confidence: 99%

Impact of tricuspid annular size reduction on right ventricular function, geometry and strain†

Malinowski

Jaźwiec

Goehler

et al. 2019

European Journal of Cardio-Thoracic Surgery

Self Cite

View full text Add to dashboard Cite

OBJECTIVES Restrictive tricuspid annuloplasty is a clinically accepted approach to treat functional tricuspid regurgitation. We set out to investigate the effect of varying degrees of tricuspid annular reduction on the right ventricular (RV) function, geometry and strain. METHODS Eight, healthy sheep (45 ± 4 kg) had 6 sonomicrometry crystals implanted around the tricuspid annulus and 20 onto the epicardium of the right ventricle defining 3 free wall regions: basal, mid and lower. A polypropylene annuloplasty suture was placed around the tricuspid annulus and externalized to an epicardial tourniquet. Simultaneous echocardiographic, haemodynamic and sonomicrometry data were acquired at baseline and during 5 consecutive annular reduction steps (TAR 1–5) with successive (5–7 mm) suture cinching. RV free wall circumferential, longitudinal and areal cardiac and interventional strains, RV radius of curvature (ROC), cross-sectional area and tricuspid annular dimensions were calculated from 3-dimensional crystal coordinates. RESULTS TAR 1–5 resulted in 19 ± 15%, 35 ± 15%, 51 ± 15%, 60 ± 15% and 68 ± 13% tricuspid annular area reduction, respectively. TAR 1 and 2 had minimal influence on the RV function, RV-ROC and strains. TAR 4 and 5 decreased RV-ROC in basal and mid-regions, but reduced the RV cross-sectional area change (from 19 ± 4% at baseline to 14 ± 3% and 13 ± 2%, respectively, P < 0.001) and circumferential and areal strains. TAR 3 significantly decreased free wall RV-ROC from 44.0 ± 1.5 to 42.6 ± 2.4 mm P < 0.001 at the RV base but maintained the regional ventricular function and strains. CONCLUSIONS In healthy ovine hearts, a tricuspid annular area reduction of ∼50% provides optimal conditions for reducing RV-ROC while maintaining regional RV function and strain patterns.

show abstract

The effect of pulmonary hypertension on ovine tricuspid annular dynamics

Abstract: The changes in tricuspid annular conformation, contractility and its 3D geometry observed during acute ovine PHT may help in the design of new pathology-specific tricuspid annular rings.

Cited by 28 publications

References 22 publications

Tricuspid annular displacement measured by 2-dimensional speckle tracking echocardiography for predicting right ventricular function in pulmonary hypertension

Tricuspid annular displacement measured by 2-dimensional speckle tracking echocardiography for predicting right ventricular function in pulmonary hypertension

Mechanics of the Tricuspid Valve—From Clinical Diagnosis/Treatment, In-Vivo and In-Vitro Investigations, to Patient-Specific Biomechanical Modeling

Impact of tricuspid annular size reduction on right ventricular function, geometry and strain†

Contact Info

Product

Resources

About