Tricuspid Regurgitation: From Imaging to Clinical Trials to Resolving the Unmet Need for Treatment

Julia Grapsa, Fabien Praz, Paul Sorajja, Joao L. Cavalcante, Marta Sitges, Maurizio Taramasso, Nicolo Piazza, David Messika-Zeitoun, Hector I. Michelena, Nadira Hamid, Julien Dreyfus, Giovanni Benfari, Edgar Argulian, Alaide Chieffo, Didier Tchetche, Lawrence Rudski, Jeroen J. Bax, Ralph Stephan von Bardeleben, Tiffany Patterson, Simon RedwoodVinayak N. Bapat, Georg Nickenig, Philipp Lurz, Jörg Hausleiter, Susheel Kodali, Rebecca T. Hahn, Francesco Maisano, Maurice Enriquez-Sarano

Research output: Contribution to journalReview articlepeer-review

3 Scopus citations


Tricuspid regurgitation (TR) is a highly prevalent and heterogeneous valvular disease, independently associated with excess mortality and high morbidity in all clinical contexts. TR is profoundly undertreated by surgery and is often discovered late in patients presenting with right-sided heart failure. To address the issue of undertreatment and poor clinical outcomes without intervention, numerous structural tricuspid interventional devices have been and are in development, a challenging process due to the unique anatomic and physiological characteristics of the tricuspid valve, and warranting well-designed clinical trials. The path from routine practice TR detection to appropriate TR evaluation, to conduction of clinical trials, to enriched therapeutic possibilities for improving TR access to treatment and outcomes in routine practice is complex. Therefore, this paper summarizes the key points and methods crucial to TR detection, quantitation, categorization, risk-scoring, intervention-monitoring, and outcomes evaluation, particularly of right-sided function, and to clinical trial development and conduct, for both interventional and surgical groups.

Original languageEnglish
Pages (from-to)79-95
Number of pages17
JournalJACC: Cardiovascular Imaging
Issue number1
StatePublished - Jan 2024


  • clinical trials
  • endpoints
  • multimodality imaging
  • structural interventions
  • tricuspid valve


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