Evaluation of tricuspid regurgitation severity: echocardiographic and clinical correlation

J Am Soc Echocardiogr. 1998 Jun;11(6):652-9. doi: 10.1016/s0894-7317(98)70042-2.


The correlation between 19 echocardiographic markers of tricuspid regurgitation (TR) severity and findings on physical examination was studied in 66 consecutive patients (age 63 +/- 12 years) with moderate or severe TR. Clinical TR was defined by two or more of the following: prominent jugular venous pulse V waves, pulsating liver, and sea-saw parasternal movement. Thirty-eight patients (57.6%) had clinical TR, whereas 28 patients (42.4%) did not. In a univariate analysis, the most powerful predictors of clinical TR (p < 0.01) were jet area > or =9 cm2, right atrial area > or =30 cm2, jet width at origin > or =0.8 cm, systolic flow reversal in the hepatic veins, paradoxical septal movement, diastolic septal flattening, inferior vena cava diameter > or =2.1 cm, and lack of inferior vena cava respiratory variation. Regurgitant index was a weaker predictor. Multivariate analysis showed that the only independent echocardiographic predictor of clinical TR was systolic flow reversal (positive and negative predictive values 91.2% and 78.1%, respectively). Significant echocardiographic TR can be subclinical in a substantial number of patients.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Echocardiography, Doppler
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Physical Examination
  • Sensitivity and Specificity
  • Tricuspid Valve Insufficiency / diagnosis
  • Tricuspid Valve Insufficiency / diagnostic imaging*