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Quantification of tricuspid regurgitation by measuring the width of the vena contracta with Doppler color flow imaging: a clinical study

Christophe M. Tribouilloy, MD^*, Maurice Enriquez-Sarano, MD^*, Kent R. Bailey, PhD, A. Jamil Tajik, MD^* and James B. Seward, MD^*

^* Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA
Section of Biostatistics, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA

View larger version (53K): [in a new window]   Figure 1 Example of tricuspid regurgitant flow from the apical view with (left) definition of the three components of the regurgitant flow and, right, measurement of the vena contracta width (crosses).

View larger version (14K): [in a new window]   Figure 2 Correlation between the vena contracta width (y axis) and the effective regurgitant orifice area (ERO, x axis) calculated by the proximal isovelocity surface area method.

View larger version (13K): [in a new window]   Figure 3 Relation between the color Doppler vena contracta width (VCW) and the presence of systolic hepatic venous flow reversal. Note the high sensitivity of a VCW of 6 mm.

View larger version (21K): [in a new window]   Figure 4 Correlations between the effective regurgitant orifice area (ERO) x axis and the jet area (left) and the jet-to-right atrial area ratio (right).

View larger version (21K): [in a new window]   Figure 5 Receiver operating characteristic curve for the diagnosis of severe tricuspid regurgitation, using as independent variables the width of the vena contracta, jet area and jet-to-right atrial (RA) area ratio. The area under the curve for the vena contracta width (0.98) is larger than for jet area (0.88, p = 0.017) and for jet-to-RA area ratio (0.85, p = 0.01).