Elsevier

Progress in Cardiovascular Diseases

Volume 61, Issues 5–6, November–December 2018, Pages 397-403
Progress in Cardiovascular Diseases

Doppler-Echocardiographic Assessment of Tricuspid Regurgitation

https://doi.org/10.1016/j.pcad.2018.11.008Get rights and content

Abstract

Compared with the vast literature concerning the echocardiographic assessment of mitral, or aortic disease, the data concerning the evaluation of tricuspid regurgitation (TR) is very limited. In this review we summarized the present data concerning the assessment of TR. We review the present knowledge concerning the pathogenesis of TR showing that it is extremely multi-factorial, thus, when assessing patients with TR by echocardiography it is imperative to focus on four major aspects: evaluation of severity of TR, assessment of the etiology of TR, evaluation of the mechanism of TR and suitability for surgical or per-cutaneous repair.

Section snippets

Suitability for surgical or per-cutaneous repair

The indication for TR repair (surgical or per-cutaneous) should be determined by an interdisciplinary Heart Team. The following aspects need to be considered:

1) Clinical indication based on the current guidelines for treatment of valve disease.

2) Mechanism of TR.

3) TR severity.

4) Availability of echocardiographic imaging windows of sufficient quality to allow reliable per-cutaneous procedural success.

5) Right ventricular function.

6) The presence and severity of pulmonary artery hypertension.

7)

Conclusions

Mild TR is common in normal individuals. In patients with more than mild TR, identifying the severity, etiology and mechanism of TR is crucial. No single Doppler and echocardiographic measurement or parameter is precise enough to quantify TR severity thus integration of multiple parameters is required. If these parameters are discordant, then TR quantitation should be performed. Etiology of TR is extremely heterogeneous, and outcome of TR is dependent on etiology, thus etiology of TR should be

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