<unk>  regurgitation (TR) results in a retrograde flow of blood into the right atrium due to the incompetent<unk>  valve. The pathophysiology of TR depends on whether TR is primary or secondary.  Primary TR results from an organic abnormality in one or more parts of the<unk>  valve, such as the leaflets, chordae tendineae, or papillary muscles. Secondary TR commonly results from hemodynamic and structural changes in the right ventricle and<unk>  valve apparatus secondary to left-sided heart pathology and/or pulmonary hypertension.<unk>  annular dilation is the most important factor in the pathophysiology of secondary TR. In addition, tethering of the leaflets and inadequate leaflet coaptation also contribute to secondary TR.
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