Doppler echocardiography in the evaluation of tricuspid stenosis

Seventeen patients (12 with native and five with prosthetictricuspid valves) with tricuspid stenosis were studied by Dopplerechocardiography followed by cardiac catheterization within24 h. The mean tricuspid diastolic pressure gradient was calculatedusing the modified Bernoulli equation. Tricuspid valve area(TVA) was calculated by the pressure half-time method (TVA =190 divided by pressure half-time). Data from Doppler echocardiographyand cardiac catheterization were compared. The Doppler-derivedtricuspid mean diastolic gradient was 1.9–9.9 mmHg (average5.3±2.5 mmHg), which correlated moderately well withthe catheterization-determined mean diastolic gradient of 2–17mmHg(average 7.3 ±4.0 mmHg), R = 0.74, standard error ofthe estimate (SEE) 1.70 mmHg, Y=0.45 x+2.00,P<0.001. TheDoppler-derived TVA was 0.56–1.58 cm² (average 1.06±0.32cm²), which correlated well with the catheterization-determinedTVA of 0.4–2.2cm² (average 1.06±0.46 cm²), R=0.81,SEE=0.20cm², Y=0.56 x+0.46, P<0.001. Of 12 patients undergoingright ventricular angiography, the angiographic and Dopplergrades of tricuspid regurgitation matched exactly in six anddiffered by one grade in the remaining six. This study demonstratedthat Doppler echocardiography compares very well to cardiaccatheterization in the quantification of tricuspid stenosisand in the assessment of concomitant tricuspid regurgitation.