Evaluation of tricuspid regurgitation severity: Echocardiographic and clinical correlation

Y. Shapira, A. Porter, M. Wurzel, M. Vaturi, A. Sagie

Research output: Contribution to journalArticlepeer-review


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 ≤9 cm* right atrial area ≤30 cm* jet width at origin ≤0.8 cm, systolic flow reversal in the hepatic veins, paradoxical septal movement, diastolic septal flattening, inferior vena cava diameter ≤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.

Original languageEnglish
Pages (from-to)652-659
Number of pages8
JournalJournal of the American Society of Echocardiography
Issue number6
StatePublished - 1998
Externally publishedYes


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