The forgotten valvulopathy and the forgotten ventricle?

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  • Letter to the Editor

    ten ventricle?

    , Mna

    Dear Editor

    and function, have important limitations in the right ventricle assess-

    [2]. What is more, recent studies have shown low correlation with the

    International Journal of Cardiology 172 (2014) e30

    Contents lists available at ScienceDirect

    International Journal of Cardiology

    j ourna l homepage: www.e lsev ie r .com/ locate / i j ca rdment. Cardiovascular magnetic resonance (Cardiac MR) has emergedas the standard of reference for RV morphology and function. It hasthe capability of providing an accurate and reproducible assessment offunction and tissue characterization [2].

    Traditionally, 2D echocardiography has been the method of choicefor evaluating RV function by means of TAPSE (tricuspid annular plane

    aging 2013 Apr;4(2):21323.[3] Souto Bayarri M, Masip Capdevila L, Remuian Pereira C, et al. Cardiac magnetic res-

    onance analysis of right ventricular function: comparison of quantication in theshort-axis and 4-chamber planes. Radiologia 2013 Apr 23, (S0033-8338(13)00067-2).

    [4] Vonk-Noordegraaf A, Souza R. Cardiac magnetic resonance imaging: what can it addto our knowledge of the right ventricle in pulmonary arterial hypertension? Am JCardiol 2012 Sep 15;110(6 Suppl.):25S31S. Corresponding author at: Cardiology Department,Universitario Central de Asturias, Avda Julin Clavera s/nTel.: +34 98510800.

    E-mail (M. Martn)

    0167-5273/$ see front matter 2014 Elsevier Ireland L of tricuspid anatomy

    ter, both 2D echocardiography and real-time-three-dimensional-echo-cardiography, although useful for the evaluattation and irreversible dysfunction. Forevaluate right ventricular size and funcWe have read with great interest and admiration the fantastic man-uscript entitled Functional tricuspid regurgitation: An underestimatedissuewhichwill be published in your journal. DiMauro et al. havewrit-ten a complete review about the forgotten valvulopathy [1]. As it is re-ferred by the authors, although severe tricuspid regurgitation can bewell tolerated during years, it has a poor prognosis. The prolonged over-load burden over right ventricle (RV) may result in its progressive dila-

    this reason, it is fundamental totion accurately. About this mat-

    For all these reasons, and in conclusion, we think that Cardiac MRplays a crucial role in the complete evaluation of RV morphology andfunction, especially in patients with severe tricuspid regurgitation be-fore surgery.


    [1] Di Mauro M, Bezante GP, Di Baldassarre A, et al. Italian Study Group on ValvularHeart Disease (Italian Society of Cardiology). Functional tricuspid regurgitation:Mara Martn a,, Cecilia Corros a, Ana Garca-Campos a

    Jos Rozado a, Vicente Barriales a, Jess de la Hera a, Elea Cardiology Department, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spainb Radiology Department, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain

    a r t i c l e i n f o

    Article history:Received 27 September 2013Accepted 21 December 2013Available online 4 January 2014

    Keywords:Tricuspid regurgitationRight ventricle functionCardiac MRArea del Corazn del Hospital33007, Oviedo, Asturias, Spain.


    td. All rights reserved.echocardiographic method [3].Usefulness of Cardiac MR goes beyond the only assessment of RV

    function, which is crucial not only in tricuspid regurgitation but alsoduring the follow-up of congenital heart diseases; it seems to be agood method for non invasive assessment and monitoring of patientswith pulmonary arterial hypertension [4]. Other frequent well-recognized indications are the evaluation of cardiomyopathies likearrytmoghenic RV dysplasia or ischaemic heart disease with involve-ment of the RV.

    an underestimated issue. Int J Cardiol 2013;168:70715.[2] Galea N, Carbone I, Cannata D, et al. Right ventricular cardiovascular magnetic reso-

    nance imaging: normal anatomy and spectrum of pathological ndings. Insights Im-ara Luisa Rodrguez a, Santiago Colunga a,Santamarta b

    systolic excursion), RV fractional area change, tissue Doppler peaksystolic velocity at the tricuspid annulus or pulsed or tissue Dopplermyocardial performance index. However, none of these methods is asuseful as Cardiac MR in the evaluation of the RV both in terms of ana-tomical delineation, function quantication and tissue characterizationThe forgotten valvulopathy and the forgot

    The forgotten valvulopathy and the forgotten ventricle?References