Prevalence and Spectrum of Conditions Associated with Severe Tricuspid Regurgitation

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