Aetiology, prevalence, and prognosis.

Area of Science:

• Cardiology
• Valvular Heart Disease

Background:

• Tricuspid regurgitation (TR) is a prevalent valvular disorder with significant morbidity and mortality.
• TR is recognized as a heterogeneous condition with distinct phenotypes, including primary, atrial secondary, ventricular secondary, and device-related TR.

Purpose of the Study:

• To highlight the increasing recognition of TR's heterogeneity and prognostic variability.
• To emphasize the need for accurate phenotyping, risk stratification, and timely intervention in TR management.

Main Methods:

• Review of contemporary population studies and disease-specific registries.
• Analysis of clinical scores (TRI-SCORE, Wang score, TRIO score) for risk stratification.
• Integration of recent staging models incorporating ventricular function, renal status, and biomarkers.

Main Results:

• Secondary TR is highly prevalent in elderly patients, those with heart failure, and candidates for transcatheter interventions.
• Prognosis differs by etiology; atrial secondary TR has better survival than ventricular secondary TR.
• TR severity is an independent predictor of mortality, necessitating refined risk stratification.

Conclusions:

• Accurate phenotyping and structured prognostic assessment are essential for optimizing TR patient care.
• Timely intervention during intermediate disease stages may improve outcomes by preventing irreversible end-organ damage.
• Advances in understanding TR phenotypes and prognostication underscore the need for improved clinical management strategies.