Severe tricuspid regurgitation: aetiology, patient characteristics, and treatment: a multicentre, prospective registry
Year: 2026
Type: article
Study design: Observational Study
Abstract: BACKGROUND AND AIMS: Severe tricuspid regurgitation (TR) is associated with increased mortality and hospitalizations for heart failure (HF). Aetiologies of TR include: secondary (atrial or ventricular), primary and cardiac implantable electronic device (CIED)-related. The aim of the study was to assess the prevalence of different TR aetiologies, as well as characteristics and treatment of patients with severe TR in a real-life setting. METHODS: This was a prospective, observational study of patients with severe TR, conducted in 18 cardiology centres. Consecutive adult patients with severe TR were included, regardless of the presence of TR symptoms and the cause of hospital admission. RESULTS: A total of 1295 patients with severe TR were enrolled (median age 76 years, 53% women). The most common reason for admission was HF decompensation (40%). Single TR aetiology was identified in 79% patients. The most frequent overlap between aetiologies included secondary ventricular and atrial TR, and was found in 11% of patients. The most common TR aetiology was secondary atrial (37%), followed by secondary ventricular (25%). Primary and CIED-related TR accounted for 10% and 15%, respectively. In 2.4% TR aetiology was not determined. Patients with secondary atrial and CIED-related TR were the oldest (79 and 78 years, respectively), and those with primary TR the youngest (68 years). Patients with CIED-related and secondary ventricular TR were more often hospitalized for HF decompensation, had more advanced HF symptoms, worse left- and right-ventricular function, worse kidney and liver function, and higher in-hospital mortality. Only 40% of patients underwent evaluation by the Heart Team and 21% were qualified for TR interventions. CONCLUSIONS: In real life, unequivocal identification of TR aetiology remains challenging. Secondary atrial TR is the most common aetiology. There are significant differences in characteristics and outcomes depending on TR aetiology. Too few patients with severe TR undergo evaluation by the Heart Team.
Source: ESC Heart Failure
Authors: Agnieszka Kapłon-Cieślicka, Adam Piasecki, Karolina Semczuk-Kaczmarek, Katarzyna Holcman, Sylwia Szczepara, Grzegorz Kopeć, Agata Krawczyk-Ożóg, Renata Rajtar-Salwa, Danuta Sorysz, Karol Kamiński, Małgorzata Knapp, Sebastian Stelmaszek, Maria Królikowska, Anna Furman-Niedziejko, Andrzej Gackowski, Agata Polańska-Szczap, Grażyna Tuskowska, Marek Koziński, Anna Tomaszuk-Kazberuk, Kinga Dudzińska, Paweł Muszyński, Ludmiła Daniłowicz-Szymanowicz, Damian Kaufmann, Małgorzata Szwoch, Beata Uziębło-Życzkowska, Małgorzata Maciorowska, Paweł Krzesiński, Agata Markiewicz, Agnieszka Bartczak-Rutkowska, Marek Grygier, Bartosz Kijewski, Robert Błaszczyk, Bartosz Kondracki, Piotr Nikodem Rudziński, Marcin Demkow, Mariusz Dębski, Tomasz Tokarek, Dominika Dykla, Aleksander Zeliaś, Rafał Gałąska, Marcin Fijałkowski, Małgorzata Niemiec, Katarzyna Mizia-Stec, Katarzyna Kurnicka, Piotr Pruszczyk, Jerzy Pręgowski, Jarosław Skowroński, Agata Bielecka-Dąbrowa, Karolina Kupczyńska, Ewa Pędzich, Ewa Ostrowska, Mariusz Tomaniak, Marcin Grabowski, Piotr Scisło, Adam Rdzanek
Institutions: Medical University of Warsaw, Jagiellonian University, John Paul II Hospital, Szpital Uniwersytecki w Krakowie, Medical University of Białystok, Gdańsk Medical University, Wojskowy Instytut Medyczny, Poznan University of Medical Sciences, Medical University of Lublin, Institute of Cardiology, Medical University of Silesia, ERN GUARD-Heart, National Institute of Geriatrics, Rheumatology and Rehabilitation, Medical University of Lodz, Polish Mother’s Memorial Hospital Research Institute
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $4,850
OpenAlex ID: W7168519624