Figure 7.

Assessment of right ventricular dysfunction and fibrosis in severe tricuspid regurgitation. (A) An example of a patient with massive tricuspid regurgitation and dilation of the right ventricle. In (B), the region of interest to measure right ventricular longitudinal strain with speckle tracking echocardiography is shown and the regional values of longitudinal strain in the free wall are presented. The time to peak longitudinal strain of the basal, mid, and apical segments of the lateral wall are presented in (C). (D) and (E) show the short-axis of the right ventricular at the level of the tricuspid valve and the 4-chamber view respectively obtained with cine-cardiac magnetic resonance imaging . On late gadolinium enhancement cardiac magnetic resonance imaging sequences, the macroscopic fibrosis can be observed in the junctional areas between the right and the left ventricles (F, arrows). Using T1 mapping techniques, microscopic fibrosis of the right and left ventricles can be measured (G).