三尖弁閉鎖不全症

関: tricuspid incompetence、tricuspid insufficiency、tricuspid regurgitation、tricuspid valve incompetence、tricuspid valve regurgitation

WordNet

a lack of competence; "pointed out the insufficiencies in my report"; "juvenile offenses often reflect an inadequacy in the parents" (同)inadequacy
(pathology) inability of a bodily part or organ to function normally
lack of an adequate quantity or number; "the inadequacy of unemployment benefits" (同)inadequacy, deficiency
control consisting of a mechanical device for controlling the flow of a fluid
device in a brass wind instrument for varying the length of the air column to alter the pitch of a tone
one of the paired hinged shells of certain molluscs and of brachiopods
the entire one-piece shell of a snail and certain other molluscs
a structure in a hollow organ (like the heart) with a flap to insure one-way flow of fluid through it
having three cusps or points (especially a molar tooth); "tricuspid molar"; "tricuspid valve" (同)tricuspidate
(of brass instruments) having valves

PrepTutorEJDIC

不十分な[点],不足;不適当,不向き
(液体・ガスなどの流れを調節する)『バルブ』,弁 / (血液の流れを調節する)弁,弁膜 / (管楽器の)バルブ / (2枚貝の)から,貝がら / 《英》真空管
(歯が)三尖の / (歯の)三尖頭

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/10/14 23:00:30」(JST)

wiki en

[Wiki en表示]

Tricuspid insufficiency (TI), a valvular heart disease also called tricuspid regurgitation (TR), refers to the failure of the heart's tricuspid valve to close properly during systole. This defect allows the blood to flow backwards, reducing its efficiency.^[1] Regurgitation may be due to a structural change of components of the tricuspid valve apparatus, a lesion can be primary (intrinsic abnormality) or secondary (right ventricular dilatation).^[2]

Signs and symptoms

Signs/symptoms of tricuspid insufficiency are generally those of right-sided heart failure, such as ascites and peripheral edema.^[2]

Tricuspid insufficiency may lead to the presence of a pansystolic heart murmur. Such a murmur is usually of low frequency and best heard low on the lower left sternal border. As with most right-sided phenomena, it tends to increase with inspiration, and decrease with expiration.However, the murmur may be inaudible indicating the relatively low pressures in the right side of the heart. A third heart sound may also be present, also heard with inspiration at the lower sternal border.^[3]^[4]

In addition to the possible ausculatory findings above, there are other signs indicating the presence of tricuspid regurgitation. There may be giant C-V waves in the jugular pulse^[5] and a palpably (and sometimes visibly) pulsatile liver on abdominal exam. Since the murmur of tricupsid regurgitation may be faint or inaudible, these signs can be helpful in establishing the diagnosis.^[6]

Causes

The causes of tricuspid insufficiency can be congenital in origin.^[7] Much more common than a congenital abnormality of the valve, however, is right ventricular dilatation of any cause. Such dilatation is most often the result left heart failure (of any cause) or pulmonary hypertension. Dilation leads to derangement of the normal anatomy and mechanics of the tricuspid valve and the muscles governing its proper function, with the result being incompetence of the tricuspid valve. Other common causes of right ventricular dilation include right ventricular infarction, inferior myocardial infarction, and cor pulmonale.^{[medical citation needed]}

Endocarditis

In regards to primary and secondary causes they are:^[8]

Primary causes
- Rheumatic
- Myxomatous
- Ebstein anomaly
- Endomyocardial fibrosis
- Endocarditis
- Traumatic (blunt chest injury)
Secondary causes
- LV dysfunction or valve disease
- Chronic lung disease
- Pulmonary thromboembolism
- Myocardial disease
- RV ischemia
- Left to right shunt

Mechanism

In terms of the mechanism of tricuspid insufficiency it involves the expansion of the tricuspid annulus(fibrous rings of heart). Tricuspid insufficiency is linked to geometry changes of the tricuspid annulus ( decreased tricuspid annular release). The leaflets shape are normal but prevented from normal working mechanism due to a distortion of spatial relationships of leaflets and chords.^[9] It is also contemplated that the process via which tricuspid regurgitation emerges, is a decrease of contraction of the myocardium around the annulus,^[10]

Diagnosis

In the diagnosis of tricuspid insufficiency a chest x-ray will demonstrate right heart enlargement. An echocardiogram will assess the chambers of the heart, as well as, right ventricular pressure. Cardiac magnetic resonance may also be used as a diagnostic tool, and finally, cardiac catheterization may determine the extent of the regurgitation.^[3]

Management

ACE inhibitor

In terms of treatment for tricuspid insufficiency prosthetic valve substitutes can be used, though artificial prostheses may cause thrombo‐embolic phenomena(bioprostheses may have a degeneration problem).^[10] Some evidence suggests that there are no significant differences between a mechanical or biological tricuspid valve in a recipient.^[11]

Generally, surgical treatment of tricuspid regurgitation is not indicated when it has arisen as a result of right ventricular dilatation. In such instances of secondary tricuspid regurgitation, the mainstay of therapy is medical. When left-sided heart failure is the cause, the individual is instructed to decrease intake of salt. Medications in this case may include diuretics and angiotensin-converting enzyme inhibitors.^[12]

Prognosis

The prognosis of tricuspid insufficiency is less favorable for males than females. Furthermore, increased tricuspid insufficiency (regurgitation) severity is an indication of a poorer prognosis according to Nath, et al.^[13] It is also important to note that since tricuspid insufficiency most often arises from left heart failure or pulmonary hypertension, the person's prognosis is usually dictated by the prognosis of the latter conditions and not by the tricuspid insufficiency per se.^{[medical citation needed]}

References

^ "Tricuspid regurgitation: MedlinePlus Medical Encyclopedia". www.nlm.nih.gov. Retrieved 2015-12-14.
^ ^a ^b "Tricuspid Regurgitation Clinical Presentation: History, Physical Examination". emedicine.medscape.com. Retrieved 2015-12-14.
^ ^a ^b "Tricuspid Valve Disease & Tricuspid regurgitation (TR) | Patient". Patient. Retrieved 2015-12-14.
^ Berg, Dale; Worzala, Katherine (2006-01-01). Atlas of Adult Physical Diagnosis. Lippincott Williams & Wilkins. p. 90. ISBN 9780781741903.
^ http://www.nejm.org/doi/full/10.1056/NEJMicm1103312
^ "http://bestpractice.bmj.com/best-practice/monograph/472/diagnosis.html"
^ Samed, Said (2014). "Management of tricuspid regurgitation in congenital heart disease: Is survival better with valve repair?". Journal of Thoracic and Cardiovascular surgery. Retrieved 15 December 2015.
^ Rogers, Jason H.; Bolling, Steven F. (2009-05-26). "The Tricuspid Valve Current Perspective and Evolving Management of Tricuspid Regurgitation". Circulation. 119 (20): 2718–2725. doi:10.1161/CIRCULATIONAHA.108.842773. ISSN 0009-7322. PMID 19470900.
^ Hung, Judy (2010-01-01). "The Pathogenesis of Functional Tricuspid Regurgitation". Seminars in Thoracic and Cardiovascular Surgery. Emerging Treatment of Stage I Non-Small Cell Lung Cancer Edited by Arjun Pennathur, MD; Functional Tricuspid Regurgitation Edited by Ani C. Anyanwu, MSc, MD, FRCS. 22 (1): 76–78. doi:10.1053/j.semtcvs.2010.05.004. – via ScienceDirect (Subscription may be required or content may be available in libraries.)
^ ^a ^b Antunes, Manuel J; Barlow, John B (2007-02-01). "Management of tricuspid valve regurgitation". Heart. 93 (2): 271–276. doi:10.1136/hrt.2006.095281. ISSN 1355-6037. PMC 1861404. PMID 17228081.
^ "BestBets: Should the tricuspid valve be replaced with a mechanical or biological valve?". www.bestbets.org. Retrieved 2015-12-14.
^ "Tricuspid Regurgitation Treatment & Management: Approach Considerations, Medical Therapy, Surgical Care".
^ "Impact of tricuspid regurgitation on long-term survival". content.onlinejacc.org. Retrieved 2015-12-14.

External links

http://www.merck.com/mmpe/sec07/ch076/ch076i.html
http://www.heartupdate.com/valvulopathy/tricuspid-valve-insufficiency_272/

UpToDate Contents

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1. 三尖弁閉鎖不全症のマネージメントおよび予後 management and prognosis of tricuspid regurgitation
2. 三尖弁閉鎖不全症の病因、臨床的特徴、および評価 etiology clinical features and evaluation of tricuspid regurgitation
3. L型大血管転位 l transposition of the great arteries
4. 三尖弁のエプスタイン奇形 ebsteins anomaly of the tricuspid valve
5. 三尖弁の心エコー評価 echocardiographic evaluation of the tricuspid valve

English Journal

Pulmonary outflow obstruction protects against heart failure in adults with congenitally corrected transposition of the great arteries.

Helsen F1, De Meester P1, Van Keer J2, Gabriels C1, Van De Bruaene A2, Herijgers P3, Rega F4, Meyns B4, Gewillig M5, Troost E2, Budts W6.
International journal of cardiology.Int J Cardiol.2015 Oct 1;196:1-6. doi: 10.1016/j.ijcard.2015.05.142. Epub 2015 May 28.
BACKGROUND: Pulmonary outflow tract obstruction (POTO) reduces systemic atrioventricular valve (SAVV) regurgitation severity in congenitally corrected transposition of the great arteries (ccTGA). Therefore, pulmonary artery banding is proposed as a palliative intervention. We aimed to investigate th
PMID 26070176

Risk factors for mortality after pericardiectomy for chronic constrictive pericarditis in a large single-centre cohort.

Busch C1, Penov K2, Amorim PA3, Garbade J4, Davierwala P4, Schuler GC5, Rastan AJ6, Mohr FW4.
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.Eur J Cardiothorac Surg.2015 Sep 15. pii: ezv322. [Epub ahead of print]
OBJECTIVES: Constrictive pericarditis (CP) is an uncommon disease with multiple causes and unclear clinical outcomes. To date, few publications have clearly defined risk factors of poor outcomes after surgery for CP. We performed a retrospective analysis of almost 100 patients undergoing surgical tr
PMID 26374871

Use of self-expanding venous cannula in tricuspid reoperation.

Piñón M1, Pradas G2, Molina D2, Legarra JJ2.
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.Eur J Cardiothorac Surg.2015 Sep;48(3):499-501. doi: 10.1093/ejcts/ezu492. Epub 2015 Jan 9.
Significant tricuspid regurgitation requiring surgical correction is associated with poor survival in patients undergoing tricuspid valve reoperations. Right chamber dilatation increases the risk of injury during resternotomy. The novel technique of peripheral cannulation using an expandable venous
PMID 25575788

Japanese Journal

小児大動脈弁疾患に対するグルタールアルデヒド処理自己心膜を用いた大動脈弁形成術

日本小児循環器学会雑誌 31(6), 329-337, 2015
NAID 130005116619

Beating Heart Versus Arrested Heart Isolated Tricuspid Valve Surgery

International Heart Journal 56(4), 400-407, 2015
NAID 130005087564

Beating Heart Versus Arrested Heart Isolated Tricuspid Valve Surgery

International Heart Journal advpub(0), 2015
NAID 130005084054

「tricuspid incompetence」

Tricuspid insufficiency
	Tricuspid regurgitation
Classification and external resources
Specialty	Cardiology
ICD-10	I07.1, I36.1, Q22.8
ICD-9-CM	397.0
MedlinePlus	000169
eMedicine	med/2314
MeSH	D014262
	[edit on Wikidata]

　　[★]

三尖弁閉鎖不全症

関: tricuspid insufficiency、tricuspid regurgitation、tricuspid valve incompetence、tricuspid valve insufficiency、tricuspid valve regurgitation

「tricuspid valve incompetence」

　　[★]

三尖弁閉鎖不全症

関: tricuspid incompetence、tricuspid insufficiency、tricuspid regurgitation、tricuspid valve insufficiency、tricuspid valve regurgitation

「tricuspid valve regurgitation」

　　[★]

三尖弁逆流、三尖弁逆流症

関: tricuspid incompetence、tricuspid regurgitation、tricuspid valve incompetence、tricuspid valve insufficiency

「insufficiency」

　　[★]

n.

不全、不全症、機能不全、機能不全症、不足、不十分、(心臓)弁閉鎖不全、弁閉鎖不全症

関: dearth、deficient、deficit、dysfunction、failing、failure、hypofunction、imperfecta、in short、inadequate、incompetence、insufficient、insufficiently、lack、low、malfunction、paucity、poorly、regurgitation、scanty、scarce、scarcity、short、shortage、shortness、stun

「tricuspid」

　　[★]

三尖弁、右房室弁

関: tricuspid valve

「valve」

　　[★]

n.

弁

[1] "Tricuspid regurgitation: MedlinePlus Medical Encyclopedia". www.nlm.nih.gov. Retrieved 2015-12-14.

[Medscape-2] "Tricuspid Regurgitation Clinical Presentation: History, Physical Examination". emedicine.medscape.com. Retrieved 2015-12-14.

[patient-3] "Tricuspid Valve Disease & Tricuspid regurgitation (TR) | Patient". Patient. Retrieved 2015-12-14.

[4] Berg, Dale; Worzala, Katherine (2006-01-01). Atlas of Adult Physical Diagnosis. Lippincott Williams & Wilkins. p. 90. ISBN 9780781741903.

[5] ttp://www.nejm.org/doi/full/10.1056/NEJMicm1103312

[6] "http://bestpractice.bmj.com/best-practice/monograph/472/diagnosis.html"

[7] Samed, Said (2014). "Management of tricuspid regurgitation in congenital heart disease: Is survival better with valve repair?". Journal of Thoracic and Cardiovascular surgery. Retrieved 15 December 2015.

[8] Rogers, Jason H.; Bolling, Steven F. (2009-05-26). "The Tricuspid Valve Current Perspective and Evolving Management of Tricuspid Regurgitation". Circulation. 119 (20): 2718–2725. doi:10.1161/CIRCULATIONAHA.108.842773. ISSN 0009-7322. PMID 19470900.

[9] Hung, Judy (2010-01-01). "The Pathogenesis of Functional Tricuspid Regurgitation". Seminars in Thoracic and Cardiovascular Surgery. Emerging Treatment of Stage I Non-Small Cell Lung Cancer Edited by Arjun Pennathur, MD; Functional Tricuspid Regurgitation Edited by Ani C. Anyanwu, MSc, MD, FRCS. 22 (1): 76–78. doi:10.1053/j.semtcvs.2010.05.004. – via ScienceDirect (Subscription may be required or content may be available in libraries.)

[antunes-10] Antunes, Manuel J; Barlow, John B (2007-02-01). "Management of tricuspid valve regurgitation". Heart. 93 (2): 271–276. doi:10.1136/hrt.2006.095281. ISSN 1355-6037. PMC 1861404. PMID 17228081.

[11] "BestBets: Should the tricuspid valve be replaced with a mechanical or biological valve?". www.bestbets.org. Retrieved 2015-12-14.

[12] "Tricuspid Regurgitation Treatment & Management: Approach Considerations, Medical Therapy, Surgical Care".

[13] "Impact of tricuspid regurgitation on long-term survival". content.onlinejacc.org. Retrieved 2015-12-14.

リンク元	「tricuspid incompetence」「tricuspid valve incompetence」「tricuspid valve regurgitation」
関連記事	「insufficiency」「tricuspid」「valve」

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tricuspid valve insufficiency