The aim of this study is to improve the definition of the two main types of secondary tricuspid regurgitation.

Inclusion Criteria:

• Any patients ≥ 18 years old, with moderate to severe tricuspid regurgitation (≥ 2/4), agreeing to participate ;
• The patients included can be ambulatory patients or stabilized hospitalised patients (meaning patient clinicaly stable, not decompensated, and whose normovolemia has been checked).
• Non opposition of the patient

Exclusion Criteria:

• Patient whose accoustic window is judged by the operator as incompatible with a precise evaluation of the tricuspid regurgitation or anatomy of the right cavity ;
• TR < grade 2 ;
• TR secondary to primary pulmonary hypertension or congenital cardiopathy ;
• Primary tricuspid regurgitation (due to rheumatic heart disease, medication - included benfluorex, due to endocarditis, valvular prolapse, carcinoid syndrom or a cardiac stimulation lead …) ;
• Significant left heart valvulopathy (Mitral regurgitation > grade 2, Aortic insufficiency > grade 2, Mitral stenosis < 2 cm², Aortic stenosis < 1.5 cm²). A valvulopathy sucessfully operated isn't considered as an exclusion criteria;
• Cardiopathy with significative systolic dysfunction (FE< 40%) ;
• Patients whose life expectantcy is less than 1 year due to a pathology independent of the TR (neoplasic process for example) ;
• Patient under judicial protection.

Patients with moderate to severe tricuspid regurgitation (≥ 2/4) diagnosed with echocardiography, in patients stabilized.