A complete noninvasive assessment of suspected tricuspid regurgitation requires two-dimensional echocardiography, color flow imaging, and continuous wave Doppler to evaluate valve morphology, right heart function, and regurgitant severity.
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Supports multimodal echo for TR assessment in practice; leaves open prospective validation of integrated protocols.
A complete noninvasive assessment of patients with suspected tricuspid regurgitation should include two-dimensional echocardiography, color flow imaging, and continuous wave Doppler. Two-dimensional echocardiography may be used to demonstrate abnormalities in tricuspid valve morphology as well as changes in right heart size and function due to tricuspid regurgitation. Color flow imaging provides a semiquantitative method for determining the presence and extent of tricuspid regurgitant jet area. When tricuspid regurgitation is present, continuous wave Doppler is used to measure right ventricular (or pulmonary artery) systolic pressure by means of the modified Bernoulli equation of 4 X regurgitant jet velocity2 plus an assumption of the value of right artrial pressure. Contrast-enhancement of tricuspid regurgitant jet signals may be necessary if continuous wave Doppler does not delineate the jet envelope.
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Waggoner et al. (1989) studied this question.
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