Salerno Nadia, Panuccio Giuseppe, Sabatino Jolanda, Leo Isabella, Torella Michele, Sorrentino Sabato, De Rosa Salvatore, Torella Daniele
Department of Experimental and Clinical Medicine, Magna Graecia University, 88100 Catanzaro, Italy.
Department of Medical and Surgical Sciences, Magna Graecia University, 88100 Catanzaro, Italy.
J Clin Med. 2023 May 14;12(10):3454. doi: 10.3390/jcm12103454.
Tricuspid valve (TV) disease is highly prevalent in the general population. For ages considered "the forgotten valve" because of the predominant interest in left-side valve disease, the TV has now received significant attention in recent years, with significant improvement both in diagnosis and in management of tricuspid disease. TV is characterized by complex anatomy, physiology, and pathophysiology, in which the right ventricle plays a fundamental role. Comprehensive knowledge of molecular and cellular mechanisms underlying TV development, TV disease, and tricuspid regurgitation-related right-ventricle cardiomyopathy is necessary to enhance TV disease understanding to improve the ability to risk stratify TR patients, while also predicting valve dysfunction and/or response to tricuspid regurgitation treatment. Scientific efforts are still needed to eventually decipher the complete picture describing the etiopathogenesis of TV and TV-associated cardiomyopathy, and future advances to this aim may be achieved by combining emerging diagnostic imaging modalities with molecular and cellular studies. Overall, basic science studies could help to streamline a new coherent hypothesis underlying both the development of TV during embryogenesis and TV-associated disease and its complications in adult life, providing the conceptual basis for the ultimate and innovative field of valve repair and regeneration using tissue-engineered heart valves.
三尖瓣疾病在普通人群中极为常见。由于以往人们主要关注左侧瓣膜疾病,三尖瓣长期以来被视为“被遗忘的瓣膜”,但近年来它已受到广泛关注,在三尖瓣疾病的诊断和治疗方面都取得了显著进展。三尖瓣具有复杂的解剖结构、生理功能和病理生理机制,其中右心室起着至关重要的作用。全面了解三尖瓣发育、三尖瓣疾病以及三尖瓣反流相关右心室心肌病的分子和细胞机制,对于增进对三尖瓣疾病的理解、提高对三尖瓣反流患者进行风险分层的能力、预测瓣膜功能障碍和/或对三尖瓣反流治疗的反应至关重要。最终破解描述三尖瓣及其相关心肌病发病机制的全貌仍需科研努力,结合新兴的诊断成像技术与分子和细胞研究可能会在这一目标上取得未来进展。总体而言,基础科学研究有助于梳理出一个新的连贯假说,解释胚胎发育过程中三尖瓣的形成以及成年期三尖瓣相关疾病及其并发症,为使用组织工程心脏瓣膜进行瓣膜修复和再生这一终极创新领域提供概念基础。