{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T08:38:54Z","timestamp":1774946334220,"version":"3.50.1"},"reference-count":11,"publisher":"IMR Press","issue":"3","license":[{"start":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T00:00:00Z","timestamp":1772755200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Cardiovasc. Med."],"abstract":"<jats:p>Background: Rheumatic heart disease (RHD) remains a prevalent cause of valvular heart pathology worldwide, especially in younger populations of low- and middle-income countries. Tricuspid valve (TV) involvement in RHD is usually secondary to left-sided valvular lesions and is often underdiagnosed, since two-dimensional echocardiography (2DE) has limited ability to visualize the complex tricuspid anatomy. Compared with 2DE, three-dimensional echocardiography (3DE) provides an en face visualization of the tricuspid valve, enabling direct planimetric measurements and detailed commissural assessment, and offers advantages for evaluating complex valvular heart disease (VHD). Thus, this study aimed to assess baseline characteristics and valvular morphology in patients with rheumatic tricuspid valve disease using 3DE. Methods: A prospective cohort single-center study conducted between April 2022 and April 2023 included 34 patients with rheumatic TV involvement. Baseline demographics, morphological features, and hemodynamic parameters were assessed using transthoracic 3DE. Results: The mean age of included patients was 45.5 \u00b1 9.1 years, and 88.2% were female. Most patients had associated left-sided valvular involvement (mitral or combined mitral and aortic). Commissural fusion (50%), leaflet thickening (82.4%), restricted mobility (85.3%), and coaptation loss (58.8%) were predominantly noted. The mean diastolic TV gradient was 3.9 \u00b1 3.4 mmHg, planimetry area 3.3 \u00b1 1.7 cm2, and estimated pulmonary artery systolic pressure 43.3 \u00b1 19.5 mmHg. Mean right ventricular (RV) global longitudinal strain was \u201323.6 \u00b1 6.1%. Conclusion: Rheumatic TV involvement is characterized by commissural fusion, leaflet thickening, and coaptation loss, highlighting the diagnostic value of 3DE in identifying morphological patterns that may guide intervention planning.<\/jats:p>","DOI":"10.31083\/rcm48678","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T07:28:46Z","timestamp":1774942126000},"source":"Crossref","is-referenced-by-count":0,"title":["Three-Dimensional Echocardiographic Evaluation of Rheumatic Tricuspid Valve Disease: A Prospective Single-Center Cohort Study"],"prefix":"10.31083","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8016-9049","authenticated-orcid":true,"given":"Mahmoud","family":"Abdelnabi","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdallah","family":"Almaghraby","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ibrahim Bin Hamad Obaidallah Hospital, 10190 Ras Al Khaimah, UAE"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moustafa","family":"Gamal","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine, Alexandria University, 5372066 Alexandria, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed Ayman","family":"Abdel-Hay","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine, Alexandria University, 5372066 Alexandria, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hoda","family":"Abdelgawad","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine, Alexandria University, 5372066 Alexandria, Egypt"},{"name":"Department of Cardiology, King\u2019s College Hospital NHS Trust, SE5 9RS London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"16242","published-online":{"date-parts":[[2026,3,6]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Kumar RK, Antunes MJ, Beaton A, Mirabel M, Nkomo VT, Okello E, et al. Contemporary Diagnosis and Management of Rheumatic Heart Disease: Implications for Closing the Gap: A Scientific Statement From the American Heart Association. Circulation. 2020; 142: e337\u2013e357.","DOI":"10.1161\/CIR.0000000000000921"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Remenyi B, ElGuindy A, Smith SC, Jr, Yacoub M, Holmes DR, Jr. Valvular aspects of rheumatic heart disease. Lancet (London, England). 2016; 387: 1335\u20131346.","DOI":"10.1016\/S0140-6736(16)00547-X"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"Otto CM, Nishimura RA, Bonow RO, Carabello BA, Erwin JP, 3rd, Gentile F, et al. 2020 ACC\/AHA Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary: A Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2021; 143: e35\u2013e71.","DOI":"10.1161\/CIR.0000000000000932"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"Volpato V, Lang RM, Yamat M, Veronesi F, Weinert L, Tamborini G, et al. Echocardiographic Assessment of the Tricuspid Annulus: The Effects of the Third Dimension and Measurement Methodology. Journal of the American Society of Echocardiography: Official Publication of the American Society of Echocardiography. 2019; 32: 238\u2013247.","DOI":"10.1016\/j.echo.2018.09.008"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Pandian NG, Kim JK, Arias-Godinez JA, Marx GR, Michelena HI, Chander Mohan J, et al. Recommendations for the Use of Echocardiography in the Evaluation of Rheumatic Heart Disease: A Report from the American Society of Echocardiography. Journal of the American Society of Echocardiography: Official Publication of the American Society of Echocardiography. 2023; 36: 3\u201328.","DOI":"10.1016\/j.echo.2022.10.009"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"Muraru D, Hahn RT, Soliman OI, Faletra FF, Basso C, Badano LP. 3-Dimensional Echocardiography in Imaging the Tricuspid Valve. JACC. Cardiovascular Imaging. 2019; 12: 500\u2013515.","DOI":"10.1016\/j.jcmg.2018.10.035"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"Abdelnabi M, Almaghraby A, Ibrahim R, Abdelgawad H. Value of three-dimensional imaging in tricuspid valve stenosis: a case series. The Egyptian Heart Journal: (EHJ): Official Bulletin of the Egyptian Society of Cardiology. 2025; 77: 76.","DOI":"10.1186\/s43044-025-00672-w"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"Escabia C, Bayes-Genis A, Delgado V. Three-Dimensional Echocardiography for Tricuspid Valve Assessment. Current Cardiology Reports. 2022; 24: 1611\u20131618.","DOI":"10.1007\/s11886-022-01780-8"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"Pothineni KR, Duncan K, Yelamanchili P, Nanda NC, Patel V, Fan P, et al. Live\/real time three-dimensional transthoracic echocardiographic assessment of tricuspid valve pathology: incremental value over the two-dimensional technique. Echocardiography (Mount Kisco, N.Y.). 2007; 24: 541\u2013552.","DOI":"10.1111\/j.1540-8175.2007.00451.x"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"Anwar AM, Geleijnse ML, Soliman OII, McGhie JS, Nemes A, ten Cate FJ. Evaluation of rheumatic tricuspid valve stenosis by real-time three-dimensional echocardiography. Heart (British Cardiac Society). 2007; 93: 363\u2013364.","DOI":"10.1136\/hrt.2006.093518"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"Gavazzoni M, Badano LP, Cascella A, Heilbron F, Tomaselli M, Caravita S, et al. Clinical Value of a Novel Three-Dimensional Echocardiography-Derived Index of Right Ventricle-Pulmonary Artery Coupling in Tricuspid Regurgitation. Journal of the American Society of Echocardiography: Official Publication of the American Society of Echocardiography. 2023; 36: 1154\u20131166.e3.","DOI":"10.1016\/j.echo.2023.06.014"}],"container-title":["Reviews in Cardiovascular Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.imrpress.com\/journal\/RCM\/27\/3\/10.31083\/RCM48678","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T07:30:22Z","timestamp":1774942222000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.imrpress.com\/journal\/RCM\/27\/3\/10.31083\/RCM48678"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,6]]},"references-count":11,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026]]}},"alternative-id":["S1530-6550(26)02207-0"],"URL":"https:\/\/doi.org\/10.31083\/rcm48678","relation":{},"ISSN":["1530-6550","2153-8174"],"issn-type":[{"value":"1530-6550","type":"print"},{"value":"2153-8174","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,6]]},"article-number":"48678"}}