Tricuspid Incompetence and Right Ventricular Output in Congestive Heart Failure

Studies of the right atrial pressure and flow curves in patients with cardiac failure show that with a venous pressure of more than 8 mm.Hg, increasing amounts of functional tricuspid regurgitation may occur (Muller and Shillingford, 1954;Korner and Shillingford, 1954).If the forward flow is maintained, backflow through the valve will add a variable amount to the right ventri- cular stroke volume.Until recently the amount of increased stroke volume caused by valvular incompetence could only be inferred from right atrial pressure curves and necropsy observations.With the development of the dye dilution technique for the quantitative estimation of regurgitant flow (Korner and Shillingford, 1955) it has now been possible to gain further knowledge of the effect of valvular incompetence on the cardiac output and its relation to heart failure.The purpose of this paper is to correlate the quantitative estimates of valvular regurgitation with the clinical and necropsy findings in a group of patients with tricuspid incompetence and to discuss these results in relation to the performance of the right ventricle in congestive heart failure.