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European Heart Journal 1998 19(4):652-659; doi:10.1053/euhj.1997.0825
Copyright © 1998 by the European Society of Cardiology.
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Comparison of the proximal flow convergence method and the jet area method for the assessment of the severity of tricuspid regurgitation

G. Grossmannf1, M. Stein, M. Kochs, M. Höher, W. Koenig, V. Hombach and M. Giesler

Department of Internal Medicine, Division of Cardiology, University of Ulm, Ulm, Germany

accepted October 13, 1997

Aims

To compare the value of the proximal flow convergence method and the jet area method for the determination of the severity of tricuspid regurgitation.

Methods and Results

The proximal isovelocity surface area radius and the jet area/length were measured in 71 consecutive patients with angiographically graded (grade 0/I–III) tricuspid regurgitation. Rank correlation coef-ficients with the angiographic grade were 0·71 (P<0·001) for the proximal isovelocity surface area radius (aliasing border of 28cm.s–1), 0·66 (P<0·001) for the jet area, and 0·63 (P<0·001) for the jet length. The proximal isovelocity surface area radius was significantly correlated with the jet area/length (correlation coefficients 0·82/0·77, P<0·001). Correct differentiation between mild to moderate (grade I–II) and severe (grade III) tricuspid regurgitation was achieved in 62 of 71 patients (87%) by means of the proximal isovelocity surface area radius, in 61 of 71 (86%) by the jet area, and in 62 of 71 (87%) by the jet length. Grade III tricuspid regurgitation was not identified in five of 21 patients (24%) by means of the proximal isovelocity surface area radius, in six of 21 (29%) by the jet area, and in seven of 21 (33%) by the jet length.

Conclusion

The flow convergence method and the jet area method are of similar value for the determination of the severity of tricuspid regurgitation. Both methods differentiated mild to moderate from severe tricuspid regurgitation in most patients. However, underestimation of severe tricuspid regurgitation in 20–30% of the cases represents a serious limitation of both methods.

Key Words: tricuspid regurgitation • colour flow Doppler imaging • proximal flow convergence region • regurgitant jet area

f1 Correspondence: Georg Grossmann, Department of Internal Medicine, Division of Cardiology, Robert Koch Strasse 8, 89081 Ulm, Germany.


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