Reference Ranges and Determinants of Tricuspid Regurgitation Velocity in Healthy Adults Assessed by Two-Dimensional Doppler-Echocardiography

Abstract

Background: Tricuspid regurgitation velocity (TRV) is the most widely used parameter by transthoracic echocardiography (TTE) in the evaluation of patients with suspected pulmonary hypertension (PH). Objectives: To explore the physiologic range of TRV in healthy adults and to investigate its clinical determinants. Methods: In the first part of the study, 614 healthy individuals (age 45.7± 14.7 years, 60.26% women) were prospectively assessed by TTE. In the second part, a pooled meta-analysis of 16 already published studies with TRV values in healthy subjects (n = 981) was performed. Statistical analysis included the calculation of 95% quantiles for defining reference ranges. Results: In the prospectively enrolled cohort, mean TRV was 2.01 ± 0.29 m/s (5–95% CI 1.987–2.033 m/s). It was significantly but weakly positively correlated with age, body mass index, systolic blood pressure, diastolic blood pressure, left atrial volume and negative with mitral inflow E/A ratio. No significant differences were found between males and females. The prospectively enrolled data revealed similar values to the literature-based datasets resulting in a mean TRV of 1.96 m/s (95% CI 1.91–2.02 m/s) and a 95% quantile of 2.55 m/s. Conclusions: To the best of our knowledge, this is the largest dataset to describe reference ranges of TRV and their clinical determinants in healthy adults years. The determined cut-off value of 2.55 m/s of this study has to be confirmed in specific pathologies such as patients at risk of PH.

Effect of Nocturnal Oxygen Therapy on Daytime Pulmonary Hemodynamics in Patients With Chronic Obstructive Pulmonary Disease Traveling to Altitude: A Randomized Controlled Trial

“…At low altitude, TRPG of the presently investigated COPD patients was 21.7 ± 5.2 mmHg and thus within a normal range and comparable with that of healthy subjects, where a tricuspid regurgitation velocity of 2.55 m/s, corresponding to a TRPG of 26 mmHg, is defined as the upper limit of normal (Marra et al, 2018).…”

Association of spectral Doppler cardiac activity in the lower limb veins and echocardiographic findings in patients with tricuspid regurgitation

“…According to the results of previous studies, age is weakly correlated with tricuspid regurgitation. However, according to the present study, the correlation is strong, with more identified patients at an advanced age compared to young individuals ( 32 ) .…”

The impact of gender in cardiovascular medicine: Lessons from the gender/sex-issue in heart failure

“…While female tends to present with reduced volumes, higher contractility and concentric remodeling, typically males HF patients are characterized by eccentric remodeling with higher volumes and reduced ejection fraction [33,34]. Usually women presents also with smaller right ventricles with concomitant RV systolic function similar to men which ultimately leads to reduced wall-stress [35][36][37][38][39][40][41]. However, although this paradigm (HFrEF in young/males, HFpEF in females) might be helpful to summaries, it does not prejudge the fact that young women/females may have HFrEF and old me/males may have HFpEF.…”