Sticchi Alessandro, Vitale Carlo, Bargagna Federico, Cardullo Alberto, Aufiero Matteo, Grassini Dario, Montuori Beatrice, Costa Giulia, Angelillis Marco, Giannini Danilo, Mazzola Matteo, Spontoni Paolo, Giannini Cristina, De Carlo Marco
University of Pisa, Pisa, Italy.
Cardio Center, Humanitas Research Hospital IRCCS, Rozzano, Italy.
Curr Cardiol Rep. 2025 Aug 13;27(1):124. doi: 10.1007/s11886-025-02269-w.
This review aims to analyze the current state of transcatheter edge-to-edge repair (T-TEER) for tricuspid regurgitation, emphasizing patient phenotypes enrolled in major trials and registries, and discussing potential pharmacological treatment strategies for this complex pathology.
Recent studies have highlighted the significant impact of tricuspid regurgitation on morbidity and mortality in patients with valvular heart disease, heart failure, and pulmonary hypertension. Advances in multimodality imaging have improved phenotyping of TR, while T-TEER trials and registries have demonstrated improvements in TR severity and quality of life. However, mortality outcomes remain neutral. Novel therapies such as SGLT2 inhibitors show promise, particularly in patients with concomitant HFpEF and HFrEF, and ongoing trials are broadening the inclusion criteria to better represent real-world populations. T-TEER represents a promising interventional strategy for managing tricuspid regurgitation, yet challenges persist due to the heterogeneous nature of the disease and differences between trial and real-world populations. Optimizing patient selection and integrating advanced imaging and novel pharmacotherapies may further enhance clinical outcomes and reduce hospitalizations, paving the way for more personalized treatment approaches.
本综述旨在分析经导管缘对缘修复术（T-TEER）治疗三尖瓣反流的现状，重点关注纳入主要试验和注册研究的患者表型，并探讨针对这种复杂病症的潜在药物治疗策略。
近期研究强调了三尖瓣反流对瓣膜性心脏病、心力衰竭和肺动脉高压患者发病率和死亡率的重大影响。多模态成像技术的进步改善了三尖瓣反流的表型分析，而T-TEER试验和注册研究表明三尖瓣反流严重程度和生活质量有所改善。然而，死亡率结果仍无明显变化。新型疗法如钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂显示出前景，尤其是在伴有射血分数保留的心力衰竭（HFpEF）和射血分数降低的心力衰竭（HFrEF）患者中，并且正在进行的试验正在扩大纳入标准以更好地代表真实世界人群。T-TEER是一种治疗三尖瓣反流的有前景的介入策略，但由于该疾病的异质性以及试验人群与真实世界人群之间的差异，挑战依然存在。优化患者选择并整合先进成像技术和新型药物疗法可能会进一步改善临床结果并减少住院次数，为更个性化的治疗方法铺平道路。
