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

• Published in: European journal of heart failure Vol. 26; no. 4; pp. 994 - 1003
• Main Authors: Dreyfus, Julien, Ruschitzka, Frank, Messika‐Zeitoun, David, Bax, Jeroen, Price, Susanna, Debonis, Michele, Prendergast, Bernard, Rosenhek, Raphael, Windecker, Stephan, Maggioni, Aldo, Lemaitre, Katell, Authier, Sebastien, Laroche, Cécile, Druais, Hervé, Goda, Artan, Mascherbauer, Julia, Linhartova, Katerina, Ihlemann, Nikolaj, Tribouilloy, Christophe, Katsaros, Andreas, Demarco, Daniela Cassar, Popescu, Bogdan, Bogachev‐Prokophiev, Alexander, Dogan, Sait Mesut, Dado, Elona, Zera, Eliverta, Heger, Maria, Muslumova, Fargana, Jahangirov, Tofig, Pierard, Luc, Van de Veire, Nico, Republic, Czech, Branny, Marian, Vondrackova, Dagmar Jungwirtova, Homza, Miroslav, Ostransky, Jiri, Abdelhamid, Magdy, Mostafa, Ahmad Elsayed, Eltobgi, Sherif, Kamal, Diaa, Iung, Bernard, Marechaux, Sylvestre, Donal, Erwan, Habib, Gilbert, Thuny, Franck, Berenfeld, Alain, Lehnert, Kristin, Akin, Ibrahim, Maier, Lars, Nickenig, Georg, Scholtz, Werner, Heintzen, Matthias, Er, Fikret, Kamperidis, Vasileios, Bartha, Elektra, Borsanyi, Tunde, Laahunova, Elmira, Erglis, Andrejs, Radauskaite, Greta, Kostovska, Elizabeta Srbinovska, Komar, Monika, Tomkiewicz‐Pajak, Lidia, Zaborska, Beata, Almeida, Ines, Freitas, Antonio, Mitre, Adriana, Popescu, Andreea, Onut, Roxana, Eminovici, Gabriela, Arsenescu‐Georgescu, Catalina, Boldyrev, Sergey, Gross, Yuriy, Kulumbegov, Oleg, Jakubov, Ramis, Stefanov, Sergei, Schneider, Yuri, Tsechanovich, Valeriy, Voronova, Tatyana, Safna, Vasilya, Koroleva, Tatyana, Tarasenko, Ivan, Verevetinov, Artem, Ruzicic, Dusan, Milosavljevic, Jelica, Valocik, Gabriel, Gomez, Ariana Gonzalez, Gallego, Irene Menduina, Caballero, Luis, Paton, Ramon Rubio, Mitroi, Cristina, Alberca, Maria Teresa, Molina‐Mora, Maria Jose, Sayar, Nurten, Bozkurt, Abdi, Gudul, Naile Eris, Mert, Kadir Ugur, Sayin, Muhammet Rasit
• Format: Journal Article Web Resource
• Language: English
• Published: Oxford, UK John Wiley & Sons, Ltd 01.04.2024; European Society of Cardiology (Wiley); Wiley-Blackwell
• Subjects: Aged; Cardiology and cardiovascular system; Cardiovascular & respiratory systems; Europe - epidemiology; Female; Guidelines; Heart Valve Diseases - diagnosis; Heart Valve Diseases - epidemiology; Human health and pathology; Human health sciences; Humans; Left-sided heart valve disease; Life Sciences; Male; Management; Middle Aged; Mitral Valve Insufficiency - diagnosis; Mitral Valve Insufficiency - epidemiology; Mitral Valve Insufficiency - surgery; Outcome; Prospective Studies; Sciences de la santé humaine; Severity of Illness Index; Systèmes cardiovasculaire & respiratoire; Tricuspid regurgitation; Tricuspid Valve; Tricuspid Valve Insufficiency - diagnosis; Tricuspid Valve Insufficiency - epidemiology; Europe; Left‐sided heart valve disease; Management; Tricuspid regurgitation; Outcome; Guidelines; Left-sided heart valve disease
• ISSN: 1388-9842; 1879-0844; 1879-0844
• DOI: 10.1002/ejhf.3157

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. Tricuspid regurgitation (TR): frequency, clinical presentation, management and outcome among patients with severe left‐sided valvular heart disease in Europe. ESC‐EORP, European Society of Cardiology‐EURObservational Research Programme; TV, tricuspid valve.