Tricuspid regurgitation epidemiology and demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rim Halaby, M.D. [2] Fatimo Biobaku M.B.B.S [3]

Overview

Tricuspid regurgitation (TR) of mild degree is common in individuals with anatomically normal valves and it has no physiological consequence. Approximately 1.6 million individuals in the USA are estimated to have moderate or severe tricuspid regurgitation. Secondary TR is more common than primary TR, accounting for more than 80% of the TR seen in clinical practice.

Epidemiology and Demographics

Incidence

Prevalence

  • Secondary tricuspid regurgitation constitutes about 80% of significant TR.[2][6]
  • The prevalence of tricuspid regurgitation is approximately 1,600,000 in USA.
  • Moderate or severe tricuspid regurgitation has been estimated to be present in up to 1·6 million individuals in the USA.[3][4]
  • The Framingham Heart Study, a prospective epidemiologic study, evaluated the prevalence and severity of TR and other valvular diseases by color Doppler examinations in 1,696 men and 1,893 women.[7]
  • The prevalence of TR (with a severity ranging from trace to ≥ moderate regurgitation) was 82% in men and 85.7% in women.
  • When trace regurgitation is excluded, the prevalence of TR of a severity ≥ mild was 14.8% in men and 18.4% in women
  • In [year], the incidence/prevalence of [disease name] was estimated to be [number range] cases per 100,000 individuals worldwide.
  • The prevalence of [disease/malignancy] is estimated to be [number] cases annually.

Age

  • Patients of all age groups may develop [disease name].
  • The severity of tricuspid regurgitation increases with age.
  • Tricuspid regurgitation associated with Ebstein anomaly can be diagnosed at birth or in early childhood.
  • Tricuspid regurgitation associated with rheumatic fever can be diagnosed usually after 15 years of age.
  • As the age increases the severity of TR also increases especially in people who are more than 70 years of age.
  • [Disease name] commonly affects individuals younger than/older than [number of years] years of age.
  • [Chronic disease name] is usually first diagnosed among [age group].
  • [Acute disease name] commonly affects [age group]
  • The prevalence of TR increases with age. Shown below are tables depicting the prevalence of TR by age and severity in men and women according to the results of the Framingham Heart Study.[8]
Severity of TR Prevalence of TR by age in men
26-29 40-49 50-59 60-69 70-83
No TR (%) 14.3 17.8 19 18.3 16.7
Trace (%) 72.7 72.5 71.5 59.8 47
Mild (% 13 9.4 9.2 21.9 25.8
Moderate or severe (%) 0 0.3 0.3 0 1.5
Severity of TR Prevalence of TR by age in women
26-29 40-49 50-59 60-69 70-83
No TR (%) 20.5 16 14.5 10.4 14.1
Trace (%) 65.1 70 70.7 62.2 56.4
Mild (% 13.2 13.5 14.1 25.7 23.9
Moderate or severe (%) 1.2 0.5 0.7 1.7 5.6

Race

  • There is no racial predilection to tricuspid regurgitation.
  • [Disease name] usually affects individuals of the [race 1] race. [Race 2] individuals are less likely to develop [disease name].

Gender

  • [Disease name] affects men and women equally.
  • Women are little more commonly affected by tricuspid regurgitation than males.
  • The progression of tricuspid regurgitation from mild to moderate to severe also based upon the gender

Prevalence

. .. The study revealed that TR is the second most common valvular regurgitation in the general population, after mitral regurgitation. The prevalence of TR (with a severity ranging from trace to ≥ moderate regurgitation) was 82% in men and 85.7% in women. When trace regurgitation is excluded, the prevalence of TR of a severity ≥ mild was 14.8% in men and 18.4% in women. The elevated prevalence of trace regurgitation can be a normal finding related to an artifact or an anatomic characteristic of the closure of the tricuspid valve.[8]

References

  1. Topilsky Y (2018). "Tricuspid valve regurgitation: epidemiology and pathophysiology". Minerva Cardioangiol. 66 (6): 673–679. doi:10.23736/S0026-4725.18.04670-4. PMID 29589671.
  2. 2.0 2.1 Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Guyton RA; et al. (2014). "2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines". J Am Coll Cardiol. 63 (22): e57–185. doi:10.1016/j.jacc.2014.02.536. PMID pmid24603191 Check |pmid= value (help).
  3. 3.0 3.1 3.2 Rodés-Cabau J, Taramasso M, O'Gara PT (2016). "Diagnosis and treatment of tricuspid valve disease: current and future perspectives". Lancet. 388 (10058): 2431–2442. doi:10.1016/S0140-6736(16)00740-6. PMID 27048553 PMID: 27048553 Check |pmid= value (help).
  4. 4.0 4.1 Taramasso M, Vanermen H, Maisano F, Guidotti A, La Canna G, Alfieri O (2012). "The growing clinical importance of secondary tricuspid regurgitation". J Am Coll Cardiol. 59 (8): 703–10. doi:10.1016/j.jacc.2011.09.069. PMID 22340261 PMID: 22340261 Check |pmid= value (help).
  5. Cohen SR, Sell JE, McIntosh CL, Clark RE (1987). "Tricuspid regurgitation in patients with acquired, chronic, pure mitral regurgitation. I. Prevalence, diagnosis, and comparison of preoperative clinical and hemodynamic features in patients with and without tricuspid regurgitation". J Thorac Cardiovasc Surg. 94 (4): 481–7. PMID 3657250.
  6. De Meester P, Van De Bruaene A, Herijgers P, Voigt JU, Budts W (2012). "Tricuspid valve regurgitation: prevalence and relationship with different types of heart disease". Acta Cardiol. 67 (5): 549–56. doi:10.1080/ac.67.5.2174129. PMID 23252005.
  7. Singh, Jagmeet P; Evans, Jane C; Levy, Daniel; Larson, Martin G; Freed, Lisa A; Fuller, Deborah L; Lehman, Birgitta; Benjamin, Emelia J (1999). "Prevalence and clinical determinants of mitral, tricuspid, and aortic regurgitation (the Framingham Heart Study)". The American Journal of Cardiology. 83 (6): 897–902. doi:10.1016/S0002-9149(98)01064-9. ISSN 0002-9149.
  8. 8.0 8.1 Singh JP, Evans JC, Levy D, Larson MG, Freed LA, Fuller DL; et al. (1999). "Prevalence and clinical determinants of mitral, tricuspid, and aortic regurgitation (the Framingham Heart Study)". Am J Cardiol. 83 (6): 897–902. PMID 10190406.

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