Parameters of Tricuspid Regurgitation on Echocardiography

  • Tricuspid Regurgitation

    Mild
    Moderate
    Severe
    Structural
    Tricuspid valve morphology Normal or mildly abnormal leaflets Moderately abnormal leaflets Severe valve lesions

    (e.g., flail leaflet, severe retraction, large perforation)
    Right atrium (Size) Usually normal

    (RA major <45mm)

    		 Normal or mild dilatation Usually dilated1

    (RA major >45mm)
    Right ventricle (Size) Usually normal

    (RVD1basal <41mm)

    		 Normal or mild dilatation Usually dilated1

    (RVD1basal >41mm)
    IVCdiameter

    Inferior vena cava diameter

    		 Normal

    (IVCdiameter <2cm)

    		 Normal or mildly dilated

    (IVCdiameter 2,1 - 2,5cm)

    		 Dilated

    (IVCdiameter >2,5cm)

    Bolded signs are considered specific for their tricuspid regurgitation grade.

    (1) RV and RA size can be within the “normal” range in patients with acute severe TR. (2) Signs are nonspecific and are influenced by many other factors (RV diastolic function, atrial fibrillation, RA pressure). (3) There are little data to support further separation of these values.

    ASE Recommendations for Noninvasive Evaluation of Native Valvular Regurgitation (2017)