Functional Mitral and Tricuspid Regurgitation across the Whole Spectrum of Left Ventricular Ejection Fraction: Recognizing the Elephant in the Room of Heart Failure

Cammalleri, Valeria; Antonelli, Giorgio; Luca, Valeria Maria De; Carpenito, Myriam; Nusca, Annunziata; Bono, Maria Caterina; Mega, Simona; Grigioni, Francesco

doi:10.3390/jcm12093316

Cited by 4 publications

(2 citation statements)

References 95 publications

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“…However, the incidence of RV failure after elective cardiac surgery is relatively low, occurring in approximately 0.1% of patients. On the other hand, in the context of heart transplant and left ventricular assist device (LVAD) implantation, the incidence significantly rises, reaching peak rates of 30-40% [2][3][4][5][6]. RV dysfunction has important clinical consequences; a study conducted by Bootsma et al involving 1109 cardiac patients demonstrated an independent association between RV dysfunction and 2-year all-cause mortality after heart surgery [7].…”

Section: The Clinical Problem: a Matter Of "Definition"mentioning

confidence: 99%

Perioperative Right Ventricular Dysfunction and Abnormalities of the Tricuspid Valve Apparatus in Patients Undergoing Cardiac Surgery

Mattei,

Strumia,

Benedetto

et al. 2023

JCM

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Right ventricular (RV) dysfunction frequently occurs after cardiac surgery and is linked to adverse postoperative outcomes, including mortality, reintubation, stroke, and prolonged ICU stays. While various criteria using echocardiography and hemodynamic parameters have been proposed, a consensus remains elusive. Distinctive RV anatomical features include its thin wall, which presents a triangular shape in a lateral view and a crescent shape in a cross-sectional view. Principal causes of RV dysfunction after cardiac surgery encompass ischemic reperfusion injury, prolonged ischemic time, choice of cardioplegia and its administration, cardiopulmonary bypass weaning characteristics, and preoperative risk factors. Post-left ventricular assist device (LVAD) implantation RV dysfunction is common but often transient, with a favorable prognosis upon resolution. There is an ongoing debate regarding the benefits of concomitant surgical repair of the RV in the presence of regurgitation. According to the literature, the gold standard techniques for assessing RV function are cardiac magnetic resonance imaging and hemodynamic assessment using thermodilution. Echocardiography is widely favored for perioperative RV function evaluation due to its accessibility, reproducibility, non-invasiveness, and cost-effectiveness. Although other techniques exist for RV function assessment, they are less common in clinical practice. Clinical management strategies focus on early detection and include intravenous drugs (inotropes and vasodilators), inhalation drugs (pulmonary vasodilators), ventilator strategies, volume management, and mechanical support. Bridging research gaps in this field is crucial to improving clinical outcomes associated with RV dysfunction in the near future.

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Section: The Clinical Problem: a Matter Of "Definition"mentioning

confidence: 99%

Perioperative Right Ventricular Dysfunction and Abnormalities of the Tricuspid Valve Apparatus in Patients Undergoing Cardiac Surgery

Mattei,

Strumia,

Benedetto

et al. 2023

JCM

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“…Even though amyloid infiltration can be found in the tricuspid valve, the fact that a significant proportion of CA patients in the study by Fagot et al exhibited tricuspid annulus dilatation suggests that the TR mechanism in CA might be similar to other forms of heart failure (mostly secondary to elevated pulmonary pressures) [ 28 , 31 , 42 , 43 ]. However, results from the UK study by Chacko and colleagues argue against this theory, as only 16% had tricuspid annulus dilatation and most patients presented with thickened and restricted valve leaflets [ 28 ].…”

Section: Tricuspid Regurgitationmentioning

confidence: 99%

Cardiac Amyloidosis and Valvular Heart Disease

Duca,

Kronberger,

Willixhofer

et al. 2023

JCM

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Growing interest has accrued in the co-existence of cardiac amyloidosis and valvular heart disease. Amyloid infiltration from either transthyretin (ATTR) or of light chain (AL) origin may affect any structure of the heart, including the valves. The recent literature has mainly focused on aortic stenosis and cardiac amyloidosis, improving our understanding of the epidemiology, diagnosis, treatment and prognosis of this dual pathology. Despite being of high clinical relevance, data on mitral/tricuspid regurgitation and cardiac amyloidosis are rather scarce and mostly limited to case reports and small cases series. It is the aim of this review article to summarize the current evidence of concomitant valvular heart disease and cardiac amyloidosis by including studies on epidemiology, diagnostic approaches, screening possibilities, therapeutic management, and prognostic implications.

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Racial and ethnic disparities in patients with severe tricuspid regurgitation: The Bronx-Valve registry

Echarte-Morales,

Scotti,

Bonnet

et al. 2025

International Journal of Cardiology

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Functional Mitral and Tricuspid Regurgitation across the Whole Spectrum of Left Ventricular Ejection Fraction: Recognizing the Elephant in the Room of Heart Failure

Cited by 4 publications

References 95 publications

Perioperative Right Ventricular Dysfunction and Abnormalities of the Tricuspid Valve Apparatus in Patients Undergoing Cardiac Surgery

Perioperative Right Ventricular Dysfunction and Abnormalities of the Tricuspid Valve Apparatus in Patients Undergoing Cardiac Surgery

Cardiac Amyloidosis and Valvular Heart Disease

Racial and ethnic disparities in patients with severe tricuspid regurgitation: The Bronx-Valve registry

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