What is the clinical evidence from this study?

Study design: Observational. Population: Functional tricuspid regurgitation (n=45). Intervention: Contrast-enhanced computed tomography vs. Transthoracic echocardiography (TR grade). Primary outcome: Risk factors for moderate or severe functional tricuspid regurgitation (OR 1.77, 95% CI 1.26-2.49, p=0.001).

What does this research mean for the field?

Systolic tricuspid annulus area and other morphological parameters measured on contrast-enhanced CT are significantly associated with the severity of functional tricuspid regurgitation. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This study aims to explore how varying grades of functional tricuspid regurgitation relate to morphological changes observed via contrast-enhanced CT.

April 1, 2026Open Access

Morphological changes in functional tricuspid regurgitation on contrast-enhanced computed tomography correlates to tricuspid regurgitation grade

Key Result

Systolic tricuspid annulus area measured on contrast-enhanced CT was significantly associated with moderate or severe functional tricuspid regurgitation (OR 1.77).

Key Points

This study aims to explore how varying grades of functional tricuspid regurgitation relate to morphological changes observed via contrast-enhanced CT.
Conducted contrast-enhanced CT on 45 patients.
Measured tricuspid annulus area, circumference, right ventricular volume, and distances between papillary muscle tips.
Classified patients into 4 groups based on tricuspid regurgitation grades.
Significant differences in TAA, TAC, RVV, and papillary muscle distances were noted among the tricuspid regurgitation groups.
Correlations with TR grade were found in TAA, TAC, RVV, and distances (r>0.40).
35.6% of cases could not identify the septal papillary muscle.

Study Design

Type

Observational (n=45)

Structured PICO

Do morphological changes of the tricuspid valve complex measured on contrast-enhanced CT correlate with functional tricuspid regurgitation severity grade?

Population

45 patients planned for cardiovascular surgery, divided into 4 groups by functional tricuspid regurgitation (FTR) grade measured by transthoracic echocardiography (none+trivial: n=26, mild: n=6, moderate: n=6, severe: n=7). Excluded: primary tricuspid regurgitation, de novo myocardial infarction within less than 28 days, unstable angina, end-stage renal failure, infective endocarditis, active hemorrhagic diseases, or postoperative pacemaker implantation.

Intervention

Morphological evaluation using contrast-enhanced computed tomography (CT) to measure tricuspid annulus area (TAA), tricuspid annulus circumference (TAC), right ventricular volume (RVV), and distances between papillary muscles in diastole and systole.

Outcome

Correlation between functional tricuspid regurgitation (FTR) severity grade and morphological parameters measured on contrast-enhanced CTsurrogate

Morphological parameters such as tricuspid annulus area and right ventricular volume measured on contrast-enhanced CT correlate positively with functional tricuspid regurgitation severity, with systolic tricuspid annulus area being a strong predictor of moderate or severe disease.

Main Result

Effect estimate: OR 1.77 (95% CI 1.26-2.49)

p-value: p=0.001

Limitations

Did not evaluate the change over time for each patient.
The true three-dimensional annulus structure might not have been evaluated because it was measured in a 2D section of contrast-enhanced CT.
Other clinical aspects such as left atrial size or atrial fibrillation were not considered in the analysis.

Abstract

PURPOSE: To examine the relationship between each severity of functional tricuspid regurgitation (FTR) and morphological evaluation on contrast-enhanced computed tomography (CT). METHODS: Forty-five patients underwent contrast-enhanced CT. Tricuspid annulus area (TAA), tricuspid annulus circumference (TAC), right ventricular volume (RVV), and the distances between the tips and bases of the papillary muscles were measured on contrast-enhanced CT in diastole and systole. The patients were classified organized into 4 groups by TR grade measured by transthoracic echocardiography (none+trivial: 26, mild: 6, moderate: 6, severe: 7), and the data were compared among the groups. RESULTS: In parameters measured on contrast-enhanced CT images, TAA, TAC, and the distances between the tips of the anterior and posterior papillary muscles in both diastole and systole and RVV in diastole were significantly different among the groups (p0.40). The septal papillary muscle could not be identified in about 1/3 (35.6%) of cases. CONCLUSIONS: TAA, TAC, RVV, and the distance between the tips of the anterior and posterior papillary muscles measured on contrast-enhanced CT images had relatively positive correlations with TR grade.

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