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三尖瓣反流管理中的当前未满足需求及解决线索

Current Unmet Needs and Clues to the Solution in the Management of Tricuspid Regurgitation.

作者信息

Sun Byung Joo, Park Jae-Hyeong

机构信息

Division of Cardiology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea.

出版信息

Korean Circ J. 2022 Jun;52(6):414-428. doi: 10.4070/kcj.2022.0117.

Abstract

Although tricuspid regurgitation (TR) is a general medical issue with growing prevalence and socioeconomic burden, most clinicians have not paid much attention to TR in the past. Several problems of TR have been pointed out in clinical practice, which include: ambiguous clinical manifestations and the difficulty in initial detection, limitations in generally used diagnostic tools, the absence of objective criterion for therapeutic intervention, high operative morbidity and mortality, and lack of long-term clinical data after the intervention for TR. Therefore, patients with TR usually visit clinicians at a much-advanced state, and this delay gives a major dilemma in clinical decision-making in a routine clinical practice. To improve the clinical outcome of TR, we need more knowledge about TR for solving the current problems and making strategies for better clinical practice. With this background, we have discussed in the present article about the pathophysiology of TR and the problems frequently experienced by clinical physicians in the diagnosis and treatment of TR. Furthermore, we have discussed the future strategy to improve the treatment of TR.

摘要

尽管三尖瓣反流(TR)是一个普遍的医学问题,其患病率和社会经济负担不断增加,但过去大多数临床医生并未对TR给予太多关注。临床实践中已指出TR的几个问题,包括:临床表现模糊且早期检测困难、常用诊断工具存在局限性、缺乏治疗干预的客观标准、手术发病率和死亡率高以及TR干预后缺乏长期临床数据。因此,TR患者通常在病情非常严重时才就医,这种延误给常规临床实践中的临床决策带来了重大困境。为改善TR的临床结局,我们需要更多关于TR的知识来解决当前问题并制定更好的临床实践策略。在此背景下,我们在本文中讨论了TR的病理生理学以及临床医生在TR诊断和治疗中经常遇到的问题。此外,我们还讨论了改善TR治疗的未来策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/556d/9160646/b10cfaf71796/kcj-52-414-g001.jpg

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