Dimitriadis Kyriakos, Pyrpyris Nikolaos, Beneki Eirini, Theofilis Panagiotis, Aznaouridis Konstantinos, Papanikolaou Aggelos, Antonopoulos Alexios, Chrysohoou Christina, Aggeli Konstantina, Tsioufis Konstantinos
First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, 115 27 Athens, Greece.
Department of Cardiology, Lausanne University Hospital and University of Lausanne, 1005 Lausanne, Switzerland.
J Cardiovasc Dev Dis. 2025 Jul 31;12(8):293. doi: 10.3390/jcdd12080293.
Tricuspid regurgitation (TR) is a well-recognized factor contributing to adverse outcomes and mortality. Recent developments in transcatheter valve repair techniques, with the emergence of tricuspid transcatheter edge-to-edge repair (TEER) devices, have altered the treatment algorithm of TR and now offer a safe and feasible alternative for the effective management of the disease and an improvement in patient symptoms. Evidence from large studies and registries showcases the benefit of tricuspid interventions in terms of heart failure hospitalization and quality of life; however, most studies do not report a significant benefit in terms of hard outcomes. Even though longer-term follow-up may be needed to identify such differences, it is important to also identify distinct patient phenotypes that would benefit the most from such interventions, moving from pure anatomical criteria to an overall assessment of the patient's clinical status. Therefore, the aim of this review is to provide updates on potential moderators of the effect of tricuspid TEER, focusing on novel anatomical criteria, right cardiac function, and renal physiology, in order to guide patient selection and provide an insightful discussion on the optimal patient phenotype for future trial design.
三尖瓣反流（TR）是导致不良后果和死亡的一个公认因素。随着经导管三尖瓣缘对缘修复（TEER）装置的出现，经导管瓣膜修复技术的最新进展改变了TR的治疗方案，现在为有效管理该疾病和改善患者症状提供了一种安全可行的替代方法。大型研究和登记处的证据表明，三尖瓣干预在心力衰竭住院率和生活质量方面具有益处；然而，大多数研究并未报告在硬性结局方面有显著益处。尽管可能需要更长时间的随访来发现此类差异，但从单纯的解剖学标准转向对患者临床状况的全面评估，识别出最能从此类干预中获益的不同患者表型也很重要。因此，本综述的目的是提供有关三尖瓣TEER效果潜在调节因素的最新信息，重点关注新的解剖学标准、右心功能和肾脏生理学，以指导患者选择，并就未来试验设计的最佳患者表型进行深入讨论。
