{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T20:39:46Z","timestamp":1792701586419,"version":"4.5.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2021,7,28]],"date-time":"2021-07-28T00:00:00Z","timestamp":1627430400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Heart Fail"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To investigate whether there is evidence for distinct cardiac output (CO) based phenotypes in patients with chronic right heart failure associated with severe tricuspid regurgitation (TR) and to characterize their impact on TR treatment and outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>\n                      A total of 132 patients underwent isolated transcatheter tricuspid valve repair (TTVR) for functional TR at two centres. Patients were clustered according to k\u2010means clustering into low [cardiac index (CI)\u2009&lt;\u20091.7\u2009L\/min\/m\n                      <jats:sup>2<\/jats:sup>\n                      ], intermediate (CI 1.7\u20132.6\u2009L\/min\/m\n                      <jats:sup>2<\/jats:sup>\n                      ) and high CO (CI\u2009&gt;\u20092.6\u2009L\/min\/m\n                      <jats:sup>2<\/jats:sup>\n                      ) clusters. All\u2010cause mortality and clinical characteristics during follow\u2010up were compared among different CO clusters. Mortality rates were highest for patients in a low (24%) and high CO state (42%, log\u2010rank\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). High CO state patients were characterized by larger inferior vena cava diameters (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.003), reduced liver function, higher incidence of ascites (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.006) and markedly reduced systemic vascular resistance (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001) as compared to TTVR patients in other CO states. Despite comparable procedural success rates, the extent of changes in right atrial pressures (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.01) and right ventricular dimensions (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001) per decrease in regurgitant volume following TTVR was less pronounced in high CO state patients as compared to other CO states. Successful TTVR was associated with the smallest prognostic benefit among low and high CO state patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients with chronic right heart failure and severe TR display distinct CO states. The high CO state is characterized by advanced congestive hepatopathy, a substantial decrease in peripheral vascular tone, a lack of response of central venous pressures to TR reduction, and worse prognosis. These data are relevant to the pathophysiological understanding and management of this important clinical syndrome.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.2307","type":"journal-article","created":{"date-parts":[[2021,7,16]],"date-time":"2021-07-16T23:44:15Z","timestamp":1626479055000},"page":"1784-1794","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":50,"title":["Cardiac output states in patients with severe functional tricuspid regurgitation: impact on treatment success and prognosis"],"prefix":"10.1093","volume":"23","author":[{"given":"Matthias","family":"Unterhuber","sequence":"first","affiliation":[{"name":"Department of Cardiology Heart Center Leipzig at University of Leipzig  Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl\u2010Patrik","family":"Kresoja","sequence":"additional","affiliation":[{"name":"Department of Cardiology Heart Center Leipzig at University of Leipzig  Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Besler","sequence":"additional","affiliation":[{"name":"Department of Cardiology Heart Center Leipzig at University of Leipzig  Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl\u2010Philipp","family":"Rommel","sequence":"additional","affiliation":[{"name":"Department of Cardiology Heart Center Leipzig at University of Leipzig  Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathias","family":"Orban","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik I, Klinikum der Universit\u00e4t M\u00fcnchen  Munich Germany"},{"name":"Munich Heart Alliance, Partner site German Centre for Cardiovascular Research (DZHK)  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximilian","family":"von Roeder","sequence":"additional","affiliation":[{"name":"Department of Cardiology Heart Center Leipzig at University of Leipzig  Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Braun","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik I, Klinikum der Universit\u00e4t M\u00fcnchen  Munich Germany"},{"name":"Munich Heart Alliance, Partner site German Centre for Cardiovascular Research (DZHK)  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"Stolz","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik I, Klinikum der Universit\u00e4t M\u00fcnchen  Munich Germany"},{"name":"Munich Heart Alliance, Partner site German Centre for Cardiovascular Research (DZHK)  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steffen","family":"Massberg","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik I, Klinikum der Universit\u00e4t M\u00fcnchen  Munich Germany"},{"name":"Munich Heart Alliance, Partner site German Centre for Cardiovascular Research (DZHK)  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonel","family":"Trebicka","sequence":"additional","affiliation":[{"name":"Translational Hepatology, Department of Internal Medicine I Goethe University Clinic Frankfurt  Frankfurt Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Zach\u00e4us","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatology, Hematology and Oncology Helios Park\u2010Klinikum Leipzig  Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rg","family":"Hausleiter","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik I, Klinikum der Universit\u00e4t M\u00fcnchen  Munich Germany"},{"name":"Munich Heart Alliance, Partner site 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