P938Normative reference values of the tricuspid valve annulus, right atrium and ventricle: a population-based study of older subjects

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Purpose: Moderate and severe tricuspid regurgitation are both associated with an adverse cardiovascular prognosis. The most common cause is mal-coaptation due to annular dilatation. The saddle-shaped tricuspid valve (TV) annulus undergoes significant change in systole requiring ranges both diastole and systole. As only small series and limited data are available, our study was conceived to establish normal TV annular dimensions in systole and diastole.Methods: A total of 480 consecutive subjects over the age of 60 were randomly recruited from the community as part of a screening project within South Birmingham. The assessment of right heart including TV was performed in apical four-chamber view by certified cardiac ultrasonographers. Tricuspid annular dimensions in end systole and end-diastole, tricuspid tenting area and distance, right atrial (RA) end systolic area, RA major and minor dimensions, right ventricular (RV) mid cavity and longitudinal dimensions were evaluated.Results: Of the 480 patients recruited, 10 with moderate to severe tricuspid regurgitation were excluded from analysis. Mean age of the subjects was 70 (±7.2) years, the majority were female (56%), with mean weight (69.5±12.9kg) and height (1.6+0.5m). Mean values (with Standard Deviation) and 5-95% percentile of various right heart measurements are given in the Table.Conclusions: These data suggest that the currently quoted upper limit of normal for the TV annulus may need to be broadened. These data also emphasise the importance of timing TV annular dimensions, since there is significant variation through the cardiac cycle.

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