Prevalence and spectrum of conditions associated with severe tricuspid regurgitation

Data regarding the prevalence and spectrum of conditions associated with severe tricuspid regurgitation (TR) are limited to small cohorts.

We retrospectively identified all patients with severe native tricuspid valve regurgitation in a large echocardiogram database between January 2004 and December 2010. Patients were classified into 1 of 3 groups based on the echocardiogram results: (1) organic TR; (2) functional TR; and (3) idiopathic TR.

Severe TR was identified in 768 (1.2%, 72 ± 16 years, 64.3% females) of 63, 472 consecutive patients referred for transthoracic echocardiography. The conditions associated with severe TR could be established in 91% of patients. The remaining 9% were classified as idiopathic severe TR with these patients being older (78 ± 10 years) and having a higher frequency of atrial fibrillation (63.8%) compared to patients with organic (65 ± 22 years; 31%) or functional severe TR (73 ± 16 years; 47.8%). Overall, organic severe TR was identified in 11.3% of all cases. Functional severe TR occurred in 79.7% of the overall cohort and was related to pulmonary hypertension and/or left-sided heart disease.

Severe TR occurred with a prevalence of 1.2% in our patients referred for echocardiography and was more common in females. Functional severe TR was the most common etiology with only a minority of cases secondary to organic severe TR. Idiopathic severe TR was found in a small proportion of patients who were older and more likely to have atrial fibrillation.