Echocardiographic grading of tricuspid regurgitation
| Mild | Moderate | Severe | Massive | Torrential | |
|---|---|---|---|---|---|
| Central jet area | < 5 cm2 | 5–10 cm2 | > 10 cm2 | ||
| Vena contracta (biplane) | < 3 mm | 3–6.9 mm | 7–13 mm | 14–20 mm | ≥ 21 mm |
| EROA (PISA) | < 20 mm2 | 20–39 mm2 | 40–59 mm2 | 60–79 mm2 | ≥ 80 mm2 |
| Vena contracta width | Not defined | < 0.70 cm | > 0.70 cm | ||
| Continuous wave jet density and contour | Soft and parabolic | Dense and variable | Dense, triangular with an early peak | ||
| Hepatic vein flow | Systolic dominance | Systolic blunting | Systolic reversal | ||
| Cardiac chambers and IVC | Normal size of RA/RV/IVC | No 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 EROA | 75–94 mm2 | 95–114 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.