A comparison of the severity of tricuspid valve regurgitation between echocardiographic and cardiac magnetic resonance criteria in adults with congenital heart disease.

Purpose: This study aims to assess the prevalence of different degrees of tricuspid regurgitation (TR) severity using cardiac magnetic resonance (CMR) and echocardiographic criteria and to examine its effect on right ventricular size and function in patients with adult congenital heart disease (ACHD). Methods and results: CMR and 2D echocardiographic data from patients with Ebstein's anomaly, atrial septal defects, and repaired Tetralogy of Fallot who were followed up at a university hospital from 2011 to 2023 were retrospectively reviewed. Patients were excluded if the interval between CMR and echocardiography exceeded 6 months or if an arrhythmia occurred during scanning. TR severity was graded using qualitative and semi-quantitative parameters. A total of 115 patients were included. The median interval between the echocardiography and CMR was 42 days. Of 115 patients, 28 patients (24.3%) had discordant TR severity between echocardiography and CMR TR volume, and 25 patients (21.7%) had discordant TR severity between echocardiography and CMR TR fraction. The number of patients with moderate or severe TR was lower when the CMR criteria were applied. The highest proportion of varying TR severity was observed in patients with Ebstein's anomaly (72.7%). The right ventricular end-diastolic volume index did not differ statistically between patients with non-severe TR, as determined by CMR and echocardiographic criteria. Conclusions: In a specific group of ACHD patients, 25% showed discordant TR severity, with the highest prevalence in those with Ebstein's anomaly. Application of CMR criteria was found to lower the overall TR severity.