The clinical characteristics, including age, sex, and reason for Doppler echocardiographic referral, are listed in Table 1. As demonstrated in Figure 1, in the majority of patients (94 percent), valvular regurgitation was detected by Doppler in at least one valve, and in many (56 percent), regurgitation was detected in two or three valves (mitral, tricuspid, and aortic).
Mitral regurgitation was detected by Doppler echocardiography in 73 percent of our study patients (Table 2), with the majority (67 percent of all patients) having either trivial or mild regurgitation. Moderate mitral regurgitation was identified in 6 percent of patients. Although the presence of mitral regurgitation was not related to age (Fig 2), the prevalence of moderate mitral regurgitation did appear to be directly age related (Fig 3). In fact, moderate mitral regurgitation was three to four times more prevalent (p<0.05) in patients aged >50 years than in those aged ^50 years.
Tricuspid regurgitation was detected in 68 percent of patients (Table 2), again with the majority having trivial or mild tricuspid regurgitation (63 percent of all patients). As with mitral regurgitation, the severity (Fig 3) but not the prevalence (Fig 2) of tricuspid regurgitation was related to age (p<0.05). Estimation of right ventricular and pulmonary artery systolic pressures was possible in 91 (44 percent) patients, with the mean pressure estimated to be 31 ± 8 mm Hg (Table 3).
Table 1—Clinical Characteristics of the Study Population (n=206)
|Mean ± SD||47 ±4|
|Sex, male.-female||66 (32):140 (68)|
|Reasons for referral|
|Global and regional ventricular function||56 (27)|
|Mitral valve prolapse||21 (10)|
|Pulmonary hypertension||6 (3)|
|Ventricular hypertrophy||4 (2)|
|Pericardial disease||4 (2)|
|Not listed||52 (25)|
Table 2—Prevalence and Severity of Doppler-Detected Mitral, Tricuspid, and Aortic Regurgitation in Patients With Normal Two-Dimensional Echocardiograms (n=206)
|Type of Regurgitation||No.(%)|
Table 3—Estimation of Bight Ventricular and Pulmonary Artery Systolic Pressure Based on Tricuspid Regurgitation Signals and Inferior Vena Cava Size and Respiratory Dynamics
|Pressure, mm Hg||No. (%)|
|Estimated right ventricular and pulmonary artery|
|Not reported||115 (56)|
|Estimated right atrial pressuret|
|Not reported||6 (3)|
Figure 1. Prevalence of Doppler-detected regurgitation of 1, 2, or 3 valves (mitral, tricuspid, and aortic) and relationship with age in patients with normal two-dimensional echocardiograms (n = 206).
Figure 2. Prevalence of Doppler-detected mitral, tricuspid, and aortic regurgitation and relation to age in patients with normal two-dimensional echocardiograms (n = 206).
Figure 3. Prevalence of moderate or severe mitral, tricuspid, and aortic regurgitation by Doppler criteria and relationship with age in patients with normal two-dimensional echocardiograms (n = 206).