OBJECTIVES The authors used transthoracic 3-dimensional transthoracic echocardiography (3DE) to characterize tricuspid annulus (TA) geometry and dynamics in healthy volunteers. BACKGROUND Accurate sizing of the TA is essential for planning tricuspid annuloplasty and for implantation of new percutaneous tricuspid devices. METHODS 3DE of the TA from 209 healthy volunteers was analyzed using custom software to measure TA area, perimeter, circularity, and dimensions at end diastole (equals tricuspid valve closure), mid-systole, end systole, and late diastole. TA intercommissural distances were measured at mid-systole. For comparison, TA diameters were measured at the same time points on multiplanar reconstruction of the 3DE datasets and on 2-dimensional transthoracic echocardiography (2DE) apical 4-chamber and right ventricular focused views. In 13 subjects with both 3DE and computed tomography, TA parameters were compared. RESULTS 3DE TA area, perimeter, and dimensions were largest in late diastole and smallest at mid-systole/end systole. Normal tricuspid valve parameters in end diastole were 8.6 ± 2.0 cm2 for area; 10.5 ± 1.2 cm for perimeter; 36 ± 4 mm and 30 ± 4 mm for longest and shortest dimensions, respectively; and 0.83 ± 0.10 for circularity. There were no age-related changes in TA parameters. Women had larger indexed TA perimeter and longer long-axis dimensions compared with men. The longest 3DE TA dimension was significantly longer than diameters measured from both 2DE and 3D multiplanar reconstruction. 3DE TA area, perimeter, and dimensions correlated with both right atrial and right ventricular volumes, suggesting that both chambers may be determinants of TA size. TA fractional area change was 35 ± 10%. Fractional changes in both perimeter and dimensions were ≥20%. When compared with computed tomography, 3DE systematically underestimated TA parameters. CONCLUSIONS Gender and body size should be taken into account to identify the reference values of TA dimensions. 2DE underestimates TA dimensions.

中文翻译：

---

三尖瓣瓣环的三维超声心动图分析为三尖瓣瓣的几何形状和动力学提供了新的见解。

目的作者使用经胸3维经胸超声心动图（3DE）来表征健康志愿者的三尖瓣环（TA）的几何形状和动力学。背景技术TA的准确尺寸对于计划三尖瓣瓣环成形术和新的经皮三尖瓣器械的植入是必不可少的。方法使用定制软件分析了209名健康志愿者的TA的3DE，以测量TA面积，周长，圆度和舒张末期（等于三尖瓣关闭），收缩中期，收缩末期和舒张末期的大小。TA室间距离是在收缩中期测量的。为了进行比较，在3DE数据集的多平面重建以及二维经胸超声心动图（2DE）心尖四腔和右心室聚焦视图的同一时间点测量了TA直径。在13位同时进行了3DE和计算机断层扫描的受试者中，比较了TA参数。结果3DE TA面积，周长和尺寸在舒张末期最大，在收缩中期/收缩末期最小。舒张末期的正常三尖瓣参数为8.6±2.0 cm2。周长为10.5±1.2厘米；最长和最短尺寸分别为36±4 mm和30±4 mm；圆形度为0.83±0.10。TA参数没有与年龄相关的变化。与男性相比，女性具有更大的索引TA周长和更长的长轴尺寸。最长的3DE TA尺寸明显长于从2DE和3D多平面重建中测得的直径。3DE TA的面积，周长和尺寸与右心房和右心室容积均相关，提示两个腔室可能是TA大小的决定因素。TA分数面积变化为35±10％。周长和尺寸的分数变化均≥20％。与计算机断层扫描相比，3DE系统地低估了TA参数。结论应考虑性别和体型来确定TA尺寸的参考值。2DE低估了TA尺寸。