{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T06:00:51Z","timestamp":1791525651683,"version":"4.3.4"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2023,6,26]],"date-time":"2023-06-26T00:00:00Z","timestamp":1687737600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"},{"start":{"date-parts":[[2023,6,26]],"date-time":"2023-06-26T00:00:00Z","timestamp":1687737600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Mitral regurgitation (MR) and tricuspid regurgitation (TR) are common in patients with heart failure (HF). The aim of this study was to investigate prevalence, clinical characteristics and outcomes of patients with or without isolated or combined MR and TR across the entire HF spectrum.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>The ESC-HFA EORP HF Long-Term Registry is a prospective, multicentre, observational study including patients with HF and 1-year follow-up data. Outpatients without aortic valve disease were included and stratified according to isolated or combined moderate\/severe MR and TR. Among 11\u2009298 patients, 7541 (67%) had no MR\/TR, 1931 (17%) isolated MR, 616 (5.5%) isolated TR and 1210 (11%) combined MR\/TR. Baseline characteristics were differently distributed across MR\/TR categories. Compared to HF with reduced ejection fraction, HF with mildly reduced ejection fraction was associated with a lower risk of isolated MR (odds ratio [OR] 0.69; 95% confidence interval [CI] 0.60\u20130.80), and distinctly lower risk of combined MR\/TR (OR 0.51; 95% CI 0.41\u20130.62). HF with preserved ejection fraction (HFpEF) was associated with a distinctly lower risk of isolated MR (OR 0.42; 95% CI 0.36\u20130.49), and combined MR\/TR (OR 0.59; 95% 0.50\u20130.70), but a distinctly increased risk of isolated TR (OR 1.94; 95% CI 1.61\u20132.33). All-cause death, cardiovascular death, HF hospitalization and combined outcomes occurred more frequently in combined MR\/TR, isolated TR and isolated MR versus no MR\/TR. The highest incident rates were observed in isolated TR and combined MR\/TR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In a large cohort of outpatients with HF, prevalence of isolated and combined MR and TR was relatively high. Isolated TR was driven by HFpEF and was burdened by an unexpectedly poor outcome.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.2929","type":"journal-article","created":{"date-parts":[[2023,6,27]],"date-time":"2023-06-27T02:04:35Z","timestamp":1687831475000},"page":"1061-1071","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":82,"title":["Prevalence, Clinical Characteristics and Outcomes of Heart Failure Patients with or Without Isolated or Combined Mitral and Tricuspid Regurgitation: An Analysis from the ESC-HFA Heart Failure Long-Term Registry"],"prefix":"10.1093","volume":"25","author":[{"given":"Marianna","family":"Adamo","sequence":"first","affiliation":[{"name":"Cardiology, ASST Spedali Civili, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia , Brescia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ovidiu","family":"Chioncel","sequence":"additional","affiliation":[{"name":"Emergency Institute for Cardiovascular Diseases \u2018Prof. C.C. Iliescu\u2019, University of Medicine Carol Davila , Bucharest ,","place":["Romania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina","family":"Benson","sequence":"additional","affiliation":[{"name":"Unit of Cardiology, Department of Medicine, Karolinska Institutet , Solna ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bahira","family":"Shahim","sequence":"additional","affiliation":[{"name":"Unit of Cardiology, Department of Medicine, Karolinska Institutet , Solna ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria G.","family":"Crespo-Leiro","sequence":"additional","affiliation":[{"name":"Unidad de Insuficiencia Cardiaca Avanzada y Trasplante Cardiaco, Complexo Hospitalario Universitario A Coruna, CHUAC, INIBIC, UDC, CIBERCV , La Coruna ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan D.","family":"Anker","sequence":"additional","affiliation":[{"name":"Department of Cardiology (CVK); and Berlin Institute of Health Center for Regenerative Therapies (BCRT); German Centre for Cardiovascular Research (DZHK) partner site Berlin, Charit\u00e9 Universit\u00e4tsmedizin Berlin , Berlin ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.S.","family":"Coats","sequence":"additional","affiliation":[{"name":"Heart Research Institute , Sydney ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerasimos","family":"Filippatos","sequence":"additional","affiliation":[{"name":"Heart Failure Unit, Department of Cardiology, University Hospital Attikon, National and Kapodistrian Univeristy of Athens , Athens ,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitja","family":"Lainscak","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Murska Sobota, Murska Sobota and Faculty of Medicine, University of Ljubljana , Ljubljana ,","place":["Slovenia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theresa","family":"McDonagh","sequence":"additional","affiliation":[{"name":"King's College Hospital , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Mebazaa","sequence":"additional","affiliation":[{"name":"Department of Anesthesia-Burn-Critical Care, UMR 942 Inserm \u2013 MASCOT; University of Paris; APHP Saint Louis Lariboisi\u00e8re University Hospitals , Paris ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo F.","family":"Piepoli","sequence":"additional","affiliation":[{"name":"Clinical Cardiology, IRCCS Policlinico San Donato, University of Milan , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe M.C.","family":"Rosano","sequence":"additional","affiliation":[{"name":"IRCCS San Raffaele Pisana , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Ruschitzka","sequence":"additional","affiliation":[{"name":"University Hospital, Clinic of Cardiology , Z\u00fcrich ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluigi","family":"Savarese","sequence":"additional","affiliation":[{"name":"Unit of Cardiology, Department of Medicine, Karolinska Institutet , Solna ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petar","family":"Seferovic","sequence":"additional","affiliation":[{"name":"University of Belgrade Faculty of Medicine , Belgrade ,","place":["Serbia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angiza","family":"Shahim","sequence":"additional","affiliation":[{"name":"Unit of Cardiology, Department of Medicine, Karolinska Institutet , Solna ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bogdan A.","family":"Popescu","sequence":"additional","affiliation":[{"name":"Emergency Institute for Cardiovascular Diseases \u2018Prof. C.C. Iliescu\u2019, University of Medicine Carol Davila , Bucharest ,","place":["Romania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard","family":"Iung","sequence":"additional","affiliation":[{"name":"Cardiology Department, Bichat Hospital, APHP, Universit\u00e9 Paris Cit\u00e9 , Paris ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Volterrani","sequence":"additional","affiliation":[{"name":"IRCCS San Raffaele , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aldo P.","family":"Maggioni","sequence":"additional","affiliation":[{"name":"ANMCO Research Center, Heart Care Foundation , Florence ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6691-8568","authenticated-orcid":false,"given":"Marco","family":"Metra","sequence":"additional","affiliation":[{"name":"Cardiology, ASST Spedali Civili, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia , Brescia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars H.","family":"Lund","sequence":"additional","affiliation":[{"name":"Unit of Cardiology, Department of Medicine, Karolinska Institutet , Solna ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,6,26]]},"reference":[{"key":"2026010913102349000_ejhf2929-bib-0001","doi-asserted-by":"crossref","first-page":"1574","DOI":"10.1002\/ejhf.813","article-title":"Epidemiology and one-year outcomes in patients with chronic heart failure and preserved, mid-range and reduced ejection fraction: An analysis of the ESC Heart Failure Long-Term Registry","volume":"19","author":"Chioncel","year":"2017","journal-title":"Eur J Heart Fail"},{"key":"2026010913102349000_ejhf2929-bib-0002","doi-asserted-by":"crossref","first-page":"2799","DOI":"10.1093\/eurheartj\/ehaa129","article-title":"Secondary valve regurgitation in patients with heart failure with preserved ejection fraction, heart failure with mid-range ejection fraction, and heart failure with reduced ejection fraction","volume":"41","author":"Bartko","year":"2020","journal-title":"Eur Heart J"},{"key":"2026010913102349000_ejhf2929-bib-0003","doi-asserted-by":"crossref","first-page":"2756","DOI":"10.1093\/eurheartj\/ehac209","article-title":"Characteristics, management, and outcomes of patients with multiple native valvular heart disease: A substudy of the EURObservational Research Programme Valvular Heart Disease II Survey","volume":"43","author":"Tribouilloy","year":"2022","journal-title":"Eur Heart J"},{"key":"2026010913102349000_ejhf2929-bib-0004","doi-asserted-by":"crossref","first-page":"1156","DOI":"10.1161\/CIRCULATIONAHA.119.041080","article-title":"Contemporary presentation and management of valvular heart disease: The EURObservational Research Programme Valvular Heart Disease II Survey","volume":"140","author":"Iung","year":"2019","journal-title":"Circulation"},{"key":"2026010913102349000_ejhf2929-bib-0005","doi-asserted-by":"crossref","first-page":"1750","DOI":"10.1002\/ejhf.2276","article-title":"Impact of mitral regurgitation in patients with worsening heart failure: Insights from BIOSTAT-CHF","volume":"23","author":"Pagnesi","year":"2021","journal-title":"Eur J Heart Fail"},{"key":"2026010913102349000_ejhf2929-bib-0006","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1093\/eurheartj\/ehx402","article-title":"Refining the prognostic impact of functional mitral regurgitation in chronic heart failure","volume":"39","author":"Goliasch","year":"2018","journal-title":"Eur Heart J"},{"key":"2026010913102349000_ejhf2929-bib-0007","article-title":"Burden, treatment use, and outcome of secondary mitral regurgitation across the spectrum of heart failure: Observational cohort study","volume":"373","author":"Bartko","year":"2021","journal-title":"BMJ"},{"key":"2026010913102349000_ejhf2929-bib-0008","doi-asserted-by":"crossref","first-page":"1675","DOI":"10.1136\/hrt.2011.225789","article-title":"Independent prognostic value of functional mitral regurgitation in patients with heart failure. 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