Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2024 Apr;26(4):994-1003.
doi: 10.1002/ejhf.3157. Epub 2024 Feb 19.

Tricuspid regurgitation: Frequency, clinical presentation, management and outcome among patients with severe left-sided valvular heart disease in Europe. Insights from the ESC-EORP Valvular Heart Disease II survey

Julien Dreyfus  1 , Monika Komar  2 , David Attias  1 , Michele De Bonis  3   4 , Frank Ruschitzka  5 , Bogdan A Popescu  6 , Cécile Laroche  7 , Christophe Tribouilloy  8 , Alexander Bogachev Prokophiev  9 , Vaida Mizariene  10 , Jeroen J Bax  11 , Aldo Pietro Maggioni  7 , David Messika-Zeitoun  12 , Alec Vahanian  13 , Bernard Iung  14 ; EORP VHD II Registry Investigators Group
Collaborators, Affiliations
Observational Study

Tricuspid regurgitation: Frequency, clinical presentation, management and outcome among patients with severe left-sided valvular heart disease in Europe. Insights from the ESC-EORP Valvular Heart Disease II survey

Julien Dreyfus et al. Eur J Heart Fail. 2024 Apr.

Abstract

Aims: Tricuspid regurgitation (TR) is commonly observed in patients with severe left-sided valvular heart disease (VHD). This study sought to assess TR frequency, management and outcome in this population.

Methods and results: Among 6883 patients with severe native left-sided VHD or previous left-sided valvular intervention enrolled in the EURObservational Research Programme prospective VHD II survey, moderate or severe TR was very frequent in patients with severe mitral VHD (30% when mitral stenosis, 36% when mitral regurgitation [MR]), especially in patients with secondary MR (46%), and rare in patients with severe aortic VHD (4% when aortic stenosis, 3% when aortic regurgitation). An increase in TR grade was associated with a more severe clinical presentation and a poorer 6-month survival (p < 0.0001). Rates of concomitant tricuspid valve (TV) intervention at the time of left-sided heart valve surgery were high at the time of mitral valve surgery (50% when mitral stenosis, 41% when MR). Concordance between class I indications (patients with severe TR) for concomitant TV surgery at the time of left-sided valvular heart surgery according to guidelines and real-practice decision-making was very good (88% overall, 95% in patients operated on for MR).

Conclusion: In this large international prospective survey among patients with severe left-sided VHD, moderate/severe TR was frequent in patients with mitral valve disease and was associated with a poorer outcome as TR grade increased. In patients with severe TR, compliance to guidelines for class I indications for concomitant TV surgery at the time of left-sided heart valve surgery was very good.

Keywords: Guidelines; Left‐sided heart valve disease; Management; Outcome; Tricuspid regurgitation.

PubMed Disclaimer

References

    1. Stuge O, Liddicoat J. Emerging opportunities for cardiac surgeons within structural heart disease. J Thorac Cardiovasc Surg 2006;132:1258–1261. https://doi.org/10.1016/j.jtcvs.2006.08.049
    1. Topilsky Y, Maltais S, Medina Inojosa J, Oguz D, Michelena H, Maalouf J, et al. Burden of tricuspid regurgitation in patients diagnosed in the community setting. JACC Cardiovasc Imaging 2019;12:433–442. https://doi.org/10.1016/j.jcmg.2018.06.014
    1. Amano M, Izumi C, Taniguchi T, Morimoto T, Miyake M, Nishimura S, et al. Impact of concomitant tricuspid regurgitation on long‐term outcomes in severe aortic stenosis. Eur Heart J Cardiovasc Imaging 2019;20:353–360. https://doi.org/10.1093/ehjci/jey105
    1. Chancellor WZ, Mehaffey JH, Beller JP, Hawkins RB, Speir AM, Quader MA, et al. Impact of tricuspid regurgitation with and without repair during aortic valve replacement. J Thorac Cardiovasc Surg 2020;162:44–50.e2. https://doi.org/10.1016/j.jtcvs.2020.02.033
    1. Essayagh B, Antoine C, Benfari G, Maalouf J, Michelena HI, Crestanello JA, et al. Functional tricuspid regurgitation of degenerative mitral valve disease: A crucial determinant of survival. Eur Heart J 2020;41:1918–1929. https://doi.org/10.1093/eurheartj/ehaa192

Publication types

LinkOut - more resources