Inversion of the radionuclide regurgitant index in right-sided XXXX .

@entity1 @entity64 @entity338 @entity997 @entity340 @entity1211
Estimation of left-sided @entity340 has been obtained using the ratio of left- to right- @entity64 counts, i.e., the regurgitant index. The present study was designed to evaluate the usefulness of the regurgitant index in identifying @entity1 with isolated right-sided @entity340 . We identified 12 @entity1 with tricuspid or @entity338 by at least two of the following criteria: pulsatile liver, positive Carvallo's sign, and @entity1211 . In 9 of the 12 @entity1 , the right-sided insufficiency was confirmed by catheterization or contrast echocardiography and flow-directed pulsed-echo Doppler. The regurgitant index in @entity1 with right-sided insufficiency was 0.59 +/- 0.23. This was significantly different from @entity1 with left-sided insufficiency (3.09 +/- 0.8; P less than 0.001) and from control subjects (1.49 +/- 0.32; P less than 0.001). In 11 of the 12 @entity1 with right-sided regurgitant lesions, the regurgitant index was less than 1.0. The hepatic expansion fraction, a possible correlate of an expansile liver, has previously been found to be both sensitive and specific for the detection of @entity1 with right-sided regurgitation. We calculated the hepatic expansion fraction in 6 @entity1 with @entity997 (including 3 with pulsatile livers) and 5 controls using the method of Handler et al.. In the present study, the hepatic expansion fraction in @entity997 @entity1 was 4.3% as compared to 4.1% in normals (P = NS). In summary, this study suggests that the regurgitant index may be a sensitive tool for the diagnosis of right-sided regurgitant lesions, while the hepatic expansion fraction does not appear to be useful for identifying @entity997 .
