Echocardiographic grading of tricuspid regurgitation

Central jet area< 5 cm25–10 cm2> 10 cm2
Vena contracta (biplane)< 3 mm3–6.9 mm7–13 mm14–20 mm≥ 21 mm
EROA (PISA)< 20 mm220–39 mm240–59 mm260–79 mm2≥ 80 mm2
Vena contracta widthNot defined< 0.70 cm> 0.70 cm
Continuous wave jet density and contourSoft and parabolicDense and variableDense, triangular with an early peak
Hepatic vein flowSystolic dominanceSystolic bluntingSystolic reversal
Cardiac chambers and IVCNormal size of RA/RV/IVCNo RV enlargement, no or mild RA enlargement, no or mild IVC enlargement with respirophasic variation. Normal RA pressure.RV/RA/IVC dilated with decreased IVC respirophasic variation. Elevated RV pressure. Diastolic intraventricular septum flattening. Reduced RV systolic function in late phase.
3D VCA or quantitative EROA75–94 mm295–114 mm2≥ 115 mm2
  • 3D VCA = three-dimensional vena contracta area; EROA = effective regurgitant orifice area; IVC = inferior vena cava; PISA = proximal isovelocity surface area; RA = right atrium; RV = right ventricle

  • Source: Data from references 1 and 12.