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Related Experiment Video

Updated: May 2, 2026

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Clinical and imaging phenotypes.

Giovanni Benfari1, Davide Margonato2, Marco Metra3

  • 1Section of Cardiology, Department of Medicine, University of Verona, Verona, Italy.

European Heart Journal Supplements : Journal of the European Society of Cardiology
|May 1, 2026
PubMed
Summary
This summary is machine-generated.

Secondary tricuspid regurgitation (STR), common in heart disease, requires understanding its causes and types for effective treatment. Differentiating between atrial (A-STR) and ventricular (V-STR) forms guides patient management and improves outcomes.

Keywords:
Cardiovascular imagingClinical phenotypesEchocardiographyOutcomeSeverity gradingTricuspid regurgitation

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Area of Science:

  • Cardiology
  • Cardiovascular Medicine
  • Cardiac Surgery

Background:

  • Functional/Secondary tricuspid regurgitation (STR) constitutes over 85% of significant tricuspid regurgitation (TR).
  • STR is linked to poor prognosis and reduced quality of life, necessitating precise etiological differentiation.
  • Advances in percutaneous tricuspid valve interventions highlight the need for detailed TR phenotyping.

Purpose of the Study:

  • To differentiate the etiologies, mechanisms, and phenotypes of secondary tricuspid regurgitation.
  • To distinguish between atrial (A-STR) and ventricular (V-STR) subtypes of STR.
  • To inform treatment strategies based on STR phenotype and underlying pathology.

Main Methods:

  • Echocardiography, emphasizing 3D imaging, is crucial for accurate TR phenotyping and procedural planning.
  • Classification of STR into A-STR (atrial dilation, annular enlargement) and V-STR (ventricular dilation/dysfunction, leaflet tethering).
  • Review of current medical, surgical, and transcatheter treatment approaches.

Main Results:

  • A-STR is associated with aging and atrial fibrillation, typically with preserved RV function.
  • V-STR indicates more advanced disease, linked to RV dysfunction, potential LV dysfunction, and higher mortality.
  • Cardiac implantable electronic device (CIED)-related TR is an emerging entity distinct from organic TR.

Conclusions:

  • Accurate phenotyping of STR using echocardiography is essential for guiding management.
  • Medical therapy is primarily symptomatic, focusing on diuretics and underlying conditions.
  • Intervention timing and STR phenotype significantly influence treatment outcomes, with both surgical and transcatheter options available.