| RV/RA/IVC size | |
|---|---|
| Utility/Advantages: | Enlargement sensitive for chronic significant TR. Normal size virtually excludes significant chronic TR |
| Limitations: | Enlargement seen in other conditions. May be normal in acute significant TR |
| TV leaflet alterations | |
| Utility/Advantages: | Flail valve specific for significant TR |
| Limitations: | Other abnormalities do not imply significant TR |
| Paradoxical septal motion (volume overload pattern) | |
| Utility/Advantages: | Simple sign of severe TR |
| Limitations: | Not specific for TR |
| Jet area–Color flow | |
| Utility/Advantages: | Simple, quick screen for TR |
| Limitations: | Subject to technical and hemodynamic factors. Underestimates severity in eccentric jets |
| Vena contracta width | |
| Utility/Advantages: | Simple, quantitative, separates mild from severe TR |
| Limitations: | Intermediate values require further confirmation |
| PISA method | |
| Utility/Advantages: | Quantitative |
| Limitations: | Validated in only a few studies |
| Flow quantitation –PW | |
| Utility/Advantages: | Quantitative |
| Limitations: | Not validated for determining TR regurgitant fraction |
| Jet profile –CW | |
| Utility/Advantages: | Simple, readily available |
| Limitations: | Qualitative, complementary data |
| Peak tricuspid E velocity | |
| Utility/Advantages: | Simple, usually increased in severe TR |
| Limitations: | Depends on RA pressure and RV relaxation, TV area, and atrial fibrillation; Complementary data only |
| Hepatic vein flow | |
| Utility/Advantages: | Simple; Systolic flow reversal is sensitive for severe TR |
| Limitations: | Influenced by RA pressure, atrial fibrillation |
CW, Continuous wave Doppler; EROA, effective orifice regurgitant area; IVC, inferior vena cava; PISA, proximal isovelocity surface area; PW, pulsed wave Doppler; RA, right atrium; RV, right ventricle; TV, tricuspid valve; TR, tricuspid regurgitation.