One-year follow-up of patients with severe tricuspid regurgitation: prognostic impact of right heart failure staging
Year: 2026
Type: article
Study design: Observational Study
Abstract: INTRODUCTION: Severe tricuspid regurgitation (STR) is associated with adverse outcomes. This nationwide registry describes the prevalence, aetiology, clinical, and echocardiographic profile of STR using contemporary classifications, and evaluates the prognostic impact of a modified right heart failure staging (RHFS). METHODS: We prospectively enrolled consecutive patients with STR from 48 centres over 6 months and followed them for 1 year. TR severity (severe, massive, torrential) and aetiology were defined using current recommendations. A modified RHFS incorporating RV remodelling and systolic dysfunction was applied. RESULTS: We included 1247 patients (mean age 76.7 ± 10.5 years; 70.2% women): 64.9% had severe TR, 24.1% massive TR, and 11.0% torrential TR. V-STR due to left-heart disease was the most frequent aetiology (49.9%), followed by A-STR (19.8%). During follow-up, HF hospitalization occurred in 20.8%, cardiovascular death in 9.2%, and 12.3% underwent tricuspid intervention. In multivariable analysis, Stages III-IV of the modified RHFS were independently associated with HF hospitalization (HR 1.58; 95% CI 1.13-2.23; P = .008) and cardiovascular mortality (HR 2.01; 95% CI 1.27-3.18; P = .003). Massive (HR 1.72; 95% CI 1.02-2.91; P = .041) and torrential TR (HR 2.57; 95% CI 1.24-5.34; P = .011) were also associated with cardiovascular mortality. CONCLUSION: Massive and torrential TR identify patients at the highest risk. The modified RHFS stratifies patients with STR into prognostic categories and may help guide the timing of intervention.
Source: ESC Heart Failure
Authors: Juan Carlos Gómez-Polo, Itziar Gómez-Salvador, Patricia Mahía Casado, Esther Pérez David, Pere Pericàs, José Antonio Parada Barcia, Carlos Izurieta, Ana Revilla Orodea, Vanessa Moñivas, Ana Testa, Lara Miguel, Irene Carrión-Sánchez, Laura Gutiérrez, José Ramón Ortega Trujillo, Nuria Hernández Vicente, Lucía Torres Quintero, Olatz Zaldua Irastorza, Mónica Delgado Ortega, Ana Osa Sáez, María Victoria Millán, María de los Ángeles Pérez, Almudena Aguilera, Isaac Pascual, Irene Méndez, Marc Abuli Lluch, Teresa Romero Delgado, Ariana González Gómez, Samuel del Castillo, Pilar Martín de la Fuente, Pedro Morillas, Daniel Gaitán, María Victoria Mogollón, Ana Payá Chaume, Alberto Bouzas, Jana Pérez, Jessica Sánchez, Ángel López Cuenca, Elvis Amao, José Carlos Fernández Camacho, Teresa Blasco, Ildefonso Roldán, Catherine Graupner, Carmen Manzano, Amparo Martínez Monzonis, Alex Ruiz Majoral, Luca Vannini, Mario Baquero, Lizandro Rodríguez, Fernando Cabrera, María Jesús Rollán, Raúl Reyes, Cristina Fernández Pérez, José Alberto San Román, Isidre Vilacosta
Institutions: Hospital Clínico San Carlos, Centro de Investigación Biomédica en Red, Hospital Clínico Universitario de Valladolid, Hospital Universitario La Paz, Hospital Universitario Son Espases, Hospital Universitari Arnau de Vilanova, Centro de Investigación en Red en Enfermedades Cardiovasculares, Hospital Universitario Puerta de Hierro Majadahonda, Hospital Universitario Lucus Augusti, Hospital Universitario Fundación Jiménez Díaz, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Hospital Universitario Ramón y Cajal, Vall d'Hebron Hospital Universitari, Hospital Universitario de Gran Canaria Doctor Negrín, Hospital Universitario Puerta del Mar, Hospital Universitario Virgen de las Nieves, Hospital Universitario Araba, Hospital Universitario Reina Sofía, Hospital Universitari i Politècnic La Fe, Hospital General Universitario de Ciudad Real, Hospital Universitario Virgen del Rocío, Universidad de Oviedo, Hospital Universitario Central de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias, Hospital Universitario Virgen Macarena, Hospital Universitari de Girona Doctor Josep Trueta, Hospital Universitario Príncipe de Asturias, Complejo Asistencial Universitario de León, Complejo Hospitalario Universitario de Granada, Hospital General Universitario de Elche, Hospital Regional Universitario de Málaga, Hospital San Pedro de Alcántara, Hospital General Universitario De Valencia, Complexo Hospitalario Universitario A Coruña, Hospital General Universitari de Castelló, Hospital General Universitario de Alicante Doctor Balmis, Hospital General Universitario Morales Meseguer, Hospital Universitari de Tortosa Verge de la Cinta, Hospital Universitario Miguel Servet, Hospital Universitario Doctor Peset, Hospital Universitario de Fuenlabrada, Hospital Universitario Severo Ochoa, Complejo Hospitalario Universitario de Santiago, Bellvitge University Hospital, Hospital Universitario Nuestra Señora de Candelaria, Hospital Virgen de la Salud, Hospital San Pedro, Hospital Clínico Universitario Virgen de la Victoria, Hospital Universitario Río Hortega, Complejo Hospitalario Torrecárdenas, Fundación Instituto para la Mejora de la Asistencia Sanitaria, Instituto de Investigación Sanitaria de Santiago, Universidad Complutense de Madrid
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $4,850
OpenAlex ID: W7124551000