BACKGROUND: The cause of tricuspid valve (TV) regurgitation (TR) occasionally remains unclear. The objectives of our study were to define the causal spectrum of severe TR diagnosed by echocardiography at a tertiary medical center and to assess the relative frequency and determine the clinical and echocardiographic characteristics of TR without an apparent cause (idiopathic TR). METHODS: Consecutive patients with severe TR were identified by the echocardiography laboratory computerized database. The echocardiographic reports of all patients were reviewed and the causes of TR were determined. The echocardiographic studies and medical charts were reviewed in patients without an obvious cause of TR. RESULTS: Of 242 consecutive patients diagnosed with severe TR, organic TV disease was evident in 23 patients (9.5%) and significant pulmonary hypertension (estimated pulmonary artery systolic pressure > 50 mm Hg) in an additional 157 patients (64.9%). After further excluding patients with various confounding factors, possibly associated with occult organic TV disease or significant pulmonary hypertension, 23 patients (9.5%) had severe TR without an apparent cause. Of these, TV coaptation appeared relatively intact, allowing adequate estimation of pulmonary artery pressure, in 15 patients (6.2% of all patients with severe TR; idiopathic TR group). Patients with idiopathic TR were older (76 +/- 10 years), with a high frequency of atrial fibrillation (93%), and prominent TV annular dilatation. CONCLUSIONS: After excluding multiple potential causes of TR, severe TR is occasionally idiopathic. Annular dilatation (secondary to aging, atrial fibrillation, or other causes) is the likely mechanism of TR in these patients.
BACKGROUND: The cause of tricuspid valve (TV) regurgitation (TR) occasionally remains unclear. The objectives of our study were to define the causal spectrum of severe TR diagnosed by echocardiography at a tertiary medical center and to assess the relative frequency and determine the clinical and echocardiographic characteristics of TR without an apparent cause (idiopathic TR). METHODS: Consecutive patients with severe TR were identified by the echocardiography laboratory computerized database. The echocardiographic reports of all patients were reviewed and the causes of TR were determined. The echocardiographic studies and medical charts were reviewed in patients without an obvious cause of TR. RESULTS: Of 242 consecutive patients diagnosed with severe TR, organic TV disease was evident in 23 patients (9.5%) and significant pulmonary hypertension (estimated pulmonary artery systolic pressure > 50 mm Hg) in an additional 157 patients (64.9%). After further excluding patients with various confounding factors, possibly associated with occult organic TV disease or significant pulmonary hypertension, 23 patients (9.5%) had severe TR without an apparent cause. Of these, TV coaptation appeared relatively intact, allowing adequate estimation of pulmonary artery pressure, in 15 patients (6.2% of all patients with severe TR; idiopathic TR group). Patients with idiopathic TR were older (76 +/- 10 years), with a high frequency of atrial fibrillation (93%), and prominent TV annular dilatation. CONCLUSIONS: After excluding multiple potential causes of TR, severe TR is occasionally idiopathic. Annular dilatation (secondary to aging, atrial fibrillation, or other causes) is the likely mechanism of TR in these patients.
Authors: Jonathan Afilalo; Julia Grapsa; Petros Nihoyannopoulos; Jonathan Beaudoin; J Simon R Gibbs; Richard N Channick; David Langleben; Lawrence G Rudski; Lanqi Hua; Mark D Handschumacher; Michael H Picard; Robert A Levine Journal: Circ Cardiovasc Imaging Date: 2015-05 Impact factor: 7.792
Authors: Karima Addetia; Francesco Maffessanti; Anuj Mediratta; Megan Yamat; Lynn Weinert; Joshua D Moss; Hemal M Nayak; Martin C Burke; Amit R Patel; Eric Kruse; Valluvan Jeevanandam; Victor Mor-Avi; Roberto M Lang Journal: J Am Soc Echocardiogr Date: 2014-08-14 Impact factor: 5.251
Authors: Mohammad Q Najib; Satya S Vittala; Suresh Challa; Amol Raizada; Fernando J Tondato; Howard R Lee; Hari P Chaliki Journal: Tex Heart Inst J Date: 2013
Authors: Ahmad Awan; Bisma Ahsan; Hasan Iftikhar; Akbar Khan; Fasil Tiruneh; Yididia Bekele; Ankit Mahajan; Ahmed A Awan Journal: Cureus Date: 2017-07-11