To investigate changes in tricuspid annulus (TA) and tricuspid valve (TV) morphology among chronic thromboembolic pulmonary hypertension (CTEPH) patients before and 12 months after pulmonary thromboendarterectomy (PEA) and compare these findings to normal control subjects. 20 CTEPH patients and 20 controls were enrolled in the study. The patients were examined with echocardiography, right heart catherization and cardiac magnetic resonance imaging prior to PEA and 12 months after. Right atrium (RA) volume was significantly reduced from baseline to 12 months after PEA (30 ± 9 vs 23 ± 5 ml/m2, p < 0.005). TA annular area in systole remained unchanged (p = 0.11) and was comparable to controls. The leaflet area, tenting volume and tenting height in systole were significantly increased at baseline but decreased significantly with comparable values to controls after 12 months (p < 0.005). There was correlation between the changes of right ventricular-pulmonary artery coupling and changes of TV tenting height (r = − 0.54, p = 0.02), TV tenting volume (r = − 0.73, p < 0.001) and TV leaflet area (− 0.57, p = 0.01) from baseline to 12 months after PEA. Tricuspid regurgitation jet area/RA area was significantly (p < 0.01) reduced from baseline (30 ± 13%) to 12 months after PEA (9 ± 10%). In CTEPH patients selected for PEA, TV tenting height, volume and valve area are significantly increased whereas annulus size and shape are less affected. The alterations in TV morphology are fully reversed after PEA and correlates to improvements of right ventricular-pulmonary arterial coupling.

中文翻译：

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慢性血栓栓塞性肺动脉高压患者肺血栓内膜切除术后三尖瓣形态和功能的逆转重塑：心脏磁共振成像和有创血流动力学研究

调查慢性血栓栓塞性肺动脉高压 (CTEPH) 患者在肺血栓内膜切除术 (PEA) 之前和之后 12 个月三尖瓣环 (TA) 和三尖瓣 (TV) 形态的变化，并将这些发现与正常对照组进行比较。20 名 CTEPH 患者和 20 名对照者参加了该研究。在 PEA 前和 12 个月后，患者接受了超声心动图、右心导管术和心脏磁共振成像检查。在 PEA 后 12 个月，右心房 (RA) 体积从基线显着减少（30 ± 9 vs 23 ± 5 ml/m2，p < 0.005）。收缩期 TA 环面积保持不变 (p = 0.11)，与对照组相当。传单区，收缩期的帐篷体积和帐篷高度在基线时显着增加，但在 12 个月后与对照组的可比值显着降低（p < 0.005）。右心室-肺动脉耦合的变化与 TV 帐篷高度（r = - 0.54，p = 0.02）、TV 帐篷体积（r = - 0.73，p < 0.001）和 TV 瓣叶面积（- 0.57）的变化存在相关性, p = 0.01) 从基线到 PEA 后 12 个月。三尖瓣反流射流面积/RA 面积显着 (p < 0.01) 从基线 (30 ± 13%) 减少到 PEA 后 12 个月 (9 ± 10%)。在选择进行 PEA 的 CTEPH 患者中，TV 帐篷高度、体积和瓣膜面积显着增加，而瓣环大小和形状受到的影响较小。