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Tricuspid Regurgitation: From imaging to clinical trials to resolving the unmet need for treatment.

JACC. Cardiovascular imaging

Authors: Julia Grapsa, Fabien Praz, Paul Sorajja, Joao L Cavalcante, Marta Sitges, Maurizio Taramasso, Nicolo Piazza, David Messika Zeitoun, Hector I Michelena, Nadira Hamid, Julien Dreyfus, Giovanni Benfari, Edgar Argulian, Alaide Chieffo, Didier Tchetche, Lawrence Rudski, Jeroen J Bax, Stephan Von Bardeleben, Tiffany Patterson, Simon Redwood, Vinayak N Bapat, Georg Nickenig, Philipp Lurz, Jörg Hausleiter, Susheel Kodali, Rebecca T Hahn, Francesco Maisano, Maurice Enriquez Sarano

Tricuspid regurgitation (TR) is a highly prevalent and heterogeneous valvular disease, independently associated with excess mortality and high morbidity in all clinical contexts. TR is profoundly undertreated by surgery and is often discovered late in patients presenting with right-sided heart failure. To address the issue of undertreatment and poor clinical outcomes without intervention, numerous structural tricuspid interventional devices have been and are in development, a challenging process due to the unique anatomic and physiologic characteristics of the tricuspid valve, and warranting well-designed clinical trials. The path from routine practice TR detection to appropriate TR evaluation, to clinical trials conduct, to enriched therapeutic possibilities for improving TR access to treatment and outcomes in routine practice is complex. Therefore, this manuscript summarizes the key points and methods crucial to TR detection, quantitation, categorization, risk-scoring, intervention-monitoring, and outcomes evaluation, particularly of right-sided function, and to clinical trial development and conduct, for both interventional and surgical groups.

Copyright © 2023. Published by Elsevier Inc.

PMID: 37731368

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