Two-dimensional assessment of tricuspid annulus dynamics and diameters: study for new reference values

Background: Tricuspid annulus (TA) size and function plays an important role in decision-making process about the need of associated TA annuloplasty during left sided cardiac surgery. Recommendations about echo assessment of TA don't indicate the view and the timing where TA should be measured. Our aim was to study TA diameters and shortening in different 2D TTE views to assess the extent of their variability. Methods: Cross-sectional study of normal volunteers. TA was measured from 3 2DTTE views (apical 4-CH, LAX-RV inflow, SAX basal) at 5 time points during cardiac cycle. TA fractional shortening diameter was obtained as (TV opening early-filling – Mid-systole) / TV opening early-filling. Result: 100pts; 42%male; 44±13yrs. TA diameters are in the Table. Fractional shortening of TA was 22±7%, 18±8%, 31±16% in 4-CH, LAX-RV inflow and SAX basal views respectively. Conclusion: This study support new references values for TA evaluation using 2D TTE. Values vary according to 2D TTE view and cardiac cycle time, showing the dynamism and complex geometry of TA