Background: The prevalence and clinical significance of tricuspid regurgitation (TR) in patients with significant left ventricular (LV) dysfunction is undetermined.
Objectives: To evaluate the prevalence of TR in a large population of patients with non valvular cardiomyopathy and association with co-existing echocardiographic findings. Patients with mechanical valves, mitral stenosis (MS), moderate to severe aortic stenosis (AS) and regurgitation (AR), were excluded.
Methods: All echocardiographic studies, performed in Rabin Medical Center between 2000 and 2013 in patients with significant LV dysfunction (EF<35%) were retrospectively evaluated for TR. Associations of TR with Mitral regurgitation (MR), pulmonary hypertension, left ventricular (LV), left atrial (LA), right ventricular (RV) dimensions and function were evaluated.
Results: The study included 4028 patients (25% female, age 68.71±13.87years). Seventy percent had non- or mild TR, 23.7% had moderate and 6.3% had severe TR. Severity of TR correlated with MR (r=0.448, p<0.001). The correlation was not affected by left ventricular end diastolic diameter (LVEDD), left ventricular end systolic diameter (LVESD), age, body mass index or gender.
Females had significantly more TR than males [8.1 vs. 5.7% had severe, 25.8 vs. 22.9% had moderate and 33.4 vs. 32.8% had mild TR; (p<0.001)].
Patients with mild TR had lower TR gradient (31±14 mmHg) than those with moderate (42±15mmHg) or severe TR (36±18mmHg); (p<0.001). Left atrial diameter and left atrial area were associated with TR severity as well (P<0.001). LVESD and LVEDD were not associated with TR severity.
Conclusion: Significant TR occurs frequently (30%) in patients with LV dysfunction. Female gender, MR, LA size and pulmonary hypertension correlate with TR severity and may have possible mechanistic and\or prognostic implications.
