Comparison of tricuspid valve regurgitation severity between the American Society of Echocardiography and the Cardiac Magnetic Resonance criteria in adults with congenital heart disease

Abstract Background Although CMR is the gold standard imaging in adult congenital heart disease (ACHD), there was also a paucity of data comparing TR severity criteria between echocardiography and CMR in ACHD patients Purpose To assess the prevalence of patients with different TR severity using cardiac magnetic resonance (CMR) and echocardiography criteria, and its effect on the right ventricular size and function in patients with adult congenital heart disease (ACHD). Methods and results The CMR and 2D echocardiography data in patients with Ebstein’s anomaly, atrial septal defects, and repaired Tetralogy of Fallot, followed up in a university hospital from 2011 – 2023, were retrospectively reviewed. Patients were excluded if the interval between CMR and echocardiography was more than 6 months or if there was an arrhythmia during scanning. The TR severity was graded according to the 2017 recommendations for noninvasive evaluation of native valvular regurgitation. A total of 115 patients were included. The median time interval between the echocardiography and CMR was 42 days. Twenty-eight out of 115 patients (24.3%) had different TR severity, of which CMR decreased TR severity in 23 out of 28 patients. The number of patients with different TR severity was highest in patients with moderate TR by echocardiography and patients with Ebstein’s anomaly (82.6% and 66.7%, respectively). The right ventricular end-diastolic volume index and the right ventricular ejection fraction did not reach statistical significance when compared with echocardiography in each TR severity group. Conclusions The TR severity was reclassified by CMR criteria in 24.3% of the specific group of ACHD patients without a significant difference in RV size and function. Patients with moderate TR and patients with Ebstein’s anomaly had the highest prevalence of discordant TR severity criteria. Table and figure legends Table 1 shows a comparison of the right ventricular parameters in each TR severity defined by echocardiography and cardiac magnetic resonance criteria. Figure 1 demonstrates the number of patients with different regurgitation severity in each imaging modality.Table 1 Figure 1