Role of Cardiac MRI in Evaluation of Tricuspid Valve Dysfunction

Abstract Background: Tricuspid valve dysfunction, and precisely tricuspid regurgitation, is very frequently encountered among cardiac patients with a complex pathophysiology and extended unfavorable complications. Aim of Study: The purpose of this study is to investigate the accuracy of cardiac MRI in Tricuspid valve dysfunction in comparison to two-dimensional transthoracic echocardiog-raphy (2D echo). Patients and Methods: This prospective study included 56 cardiac patients, who were evaluated for tricuspid valve dysfunction group. All were investigated by 2D transthoracic echo and cardiac MRI which was done maximally at a week interval after echo. Agreement between echocardiography and MRI as regard valve morphology, area, mean pressure gradient, regurgitation fraction and volume as well as right and left ventricular volumes and function were calculated. Results: There is significant strong positive correlation between MRI and echo as regard tricuspid valve area (r=0.991, p < 0.001) and mean pressure gradient (r=0.996 p < 0.001). The two methods were significantly (r=0.991, p < 0.001). Cohen's kappa agreement test was done to calculate agreement between MRI and echocardiography for morphological and functional Tricusped valve assessment. There is strong agreement (k=0.8, p < 0.001) between MRI and echo as regard: Regurgitant jet area and regurgitation fraction while, moderate agreement in cusp thickness and regurgitant jet location (k=0.78,0.61 p=0.003). Leaflet mobility shows weak agreement (k=0.58, p=0.001) and there was no agreement regarding cusp calcifi-cation. There was strong positive correlation between echo and MRI as regard right and left ventricles ejection fraction in tricuspid valve disease (r=0.93, p=0.01 & r=0.87, p=0.003 respectively). Conclusion: MRI is an accurate method for evaluation of tricuspid valve dysfunction with good correlation with echo.