JACC: CARDIOVASCULAR IMAGING

VOL. 7, NO. 12, 2014

ª 2014 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION

ISSN 1936-878X/$36.00

PUBLISHED BY ELSEVIER INC.

http://dx.doi.org/10.1016/j.jcmg.2014.08.008

EDITORIAL COMMENT

Severe Tricuspid Valve Regurgitation Is Not an Innocent Finding to Be Ignored!* Gösta B. Pettersson, MD, PHD,y L. Leonardo Rodriguez, MD,z Eugene H. Blackstone, MDyx

I

n this issue of iJACC, Topilsky et al. (1) at

echocardiographic variables collected from patients

the Mayo Clinic present a provocative study on

with more severe TR, including estimation of RV sys-

the clinical outcome of isolated tricuspid regur-

tolic pressure as a surrogate for pulmonary artery

gitation (TR). These authors studied the late out-

pressure.

comes of patients with isolated TR collected in a

The results of this study show that of several

program of TR quantification that enrolled patients

measures collected from 1 clinical and 1 echocardio-

with holosystolic TR from 1995 to 2005. In this study,

graphic examination, TR quantification by regur-

isolated TR included patients with no other important

gitant orifice area (PISA) was the most predictive of

valvular or other cardiac disease, but included pa-

adverse outcomes. Although the visual qualitative

tients with atrial fibrillation and elevated right ven-

estimation of TR severity was useful to identify the

tricular (RV) systolic pressure to