Right Ventricular Function in Patients With Significant Tricuspid Regurgitation

Area of Science:

• Cardiology
• Cardiac Imaging
• Echocardiography

Background:

• Significant tricuspid regurgitation (TR) is a key factor in patient morbidity and mortality.
• Right ventricular (RV) systolic function is critical for managing TR, influencing symptoms, treatment response, and outcomes.
• The RV's sensitivity to hemodynamic changes necessitates accurate functional assessment for risk stratification and intervention planning.

Purpose of the Study:

• To review the pathophysiology, quantitative thresholds, and prognostic significance of RV function assessment in patients with significant TR.
• To emphasize the importance of RV function evaluation in contemporary TR management.

Main Methods:

• Echocardiography, including TAPSE, RVFAC, S', speckle-tracking, and 3D imaging, is the primary tool for RV function assessment.
• Cardiac magnetic resonance (CMR) imaging serves as the reference standard for precise RV volumetric and functional parameter evaluation.
• Review of existing literature on RV function assessment in TR.

Main Results:

• Impaired RV systolic function consistently predicts adverse outcomes in severe TR, including heart failure progression, reduced exercise tolerance, and decreased survival.
• Interventions performed before advanced RV impairment offer symptomatic and survival benefits.
• Accurate quantification of RV dysfunction is vital for optimizing therapeutic timing and type.

Conclusions:

• Early recognition and quantification of RV dysfunction are crucial for timely therapy in significant TR.
• RV function assessment plays a pivotal role in the contemporary management of TR.
• Optimizing RV function assessment aids in improving patient outcomes and survival.