Tricuspid valve regurgitation: prevalence and relationship with different types of heart disease

Abstract

Objectives: The clinical impact of tricuspid valve regurgitation (TR) is in most cases undetermined.This study aimed at evaluating: (1) the prevalence of TR, (2) the degree of its relationship with several types of heart disease and (3) the association of the routine echocardiographic variables with TR in each cardiac pathology.

Methods and results: The database of the University Hospitals of Leuven was searched for all transthoracic echocardiographic studies, performed between November 2010 and January 2011, to reach a target of at least 2000 patients. The study population was divided into predefined categories. Significant TR was defined as graded > 2/4 on colour Doppler. In total 2054 consecutive echocardiographic studies were retrieved. The prevalence of significant TR was 10.2% in the total population, ranging from 1.1% to 34.4%. TR was strongly associated with pulmonary arterial hypertension (PAH) [OR 35.8 (11.7-110.3; P < 0.001)], valvular heart disease [OR 6.7 (2.3-19.2; P < 0.001)], heart transplantation [OR 10.4 (3.4-31.8; P < 0.001)], non-ischaemic cardiomyopathy [OR 6.2 (1.8-21.3; P = 0.004)], and ischaemic cardiomyopathy [OR 5.6 (1.5-21.8; P = 0.012)]. TR was significantly related to the degree of mitral valve regurgitation (MR) in all categories (P < 0.001).

Conclusion: TR occurs frequently and is in a different degree related to the underlying heart disease. TR was also associated to MR. This might suggest valvular interdependence between the tricuspid and mitral valves.