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This study aimed to assess mortality associated with significant TR, focusing on the role of valvular disease etiology and other predictive factors.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>This is a retrospective, multicenter, cohort observational study, including all consecutive patients with moderate-to-severe or greater TR. The patients were classified into five etiological groups: organic TR, TR secondary to left valvulopathy, TR secondary to left or right ventricular dysfunction, TR secondary to pulmonary hypertension, and atrial TR. The long-term mortality was assessed (median follow-up: 39.8\u00a0months).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>757 patients were included. The overall mortality incidence rate was 162.5 deaths per 1000 patient-years. Compared to atrial TR, all other etiologies presented a higher mortality risk: organic TR adjusted hazard ratio (aHR)\u2009=\u20092.344 (95% confidence interval [CI]: 1.138\u20134.829), left valvulopathy-related TR aHR\u2009=\u20091.901 (95% CI: 1.011\u20133.574), ventricular dysfunction-related TR aHR\u2009=\u20093.683 (95% CI: 1.627\u20138.338), and pulmonary hypertension-related TR aHR\u2009=\u20092.446 (95% CI: 1.215\u20134.927). In addition to known factors, male sex was associated with a higher mortality risk (aHR\u2009=\u20091.608, 1.175\u20132.201), while beta-blocker use was linked to a lower risk (aHR\u2009=\u20090.674, 0.502\u20130.904).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>In a large cohort of patients with significant TR, and after adjusting for clinical and echocardiographic variables, all etiological groups exhibited a higher mortality risk compared to atrial TR. Additionally, male patients with TR had a higher mortality risk, while beta-blocker therapy emerged as a protective factor.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00392-025-02662-z","type":"journal-article","created":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T11:12:44Z","timestamp":1746702764000},"page":"915-926","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Etiology of tricuspid regurgitation and mortality: a multicenter cohort study"],"prefix":"10.1007","volume":"114","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6650-6264","authenticated-orcid":false,"given":"Jorge","family":"Rodr\u00edguez-Capit\u00e1n","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paloma","family":"M\u00e1rquez-Camas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jes\u00fas","family":"Carmona-Carmona","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego F\u00e9lix","family":"Arroyo Mo\u00f1ino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marinela","family":"Chaparro-Mu\u00f1oz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mat\u00edas","family":"Soler-Gonz\u00e1lez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Garc\u00eda del R\u00edo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teodora","family":"Egido de la Iglesia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Segovia-Reyes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mora","family":"Murri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Ra\u00fal","family":"L\u00f3pez Salguero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Couto-Mall\u00f3n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Romero-Cuevas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco Javier","family":"Pav\u00f3n-Mor\u00f3n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0898-8212","authenticated-orcid":false,"given":"Mario","family":"Guti\u00e9rrez-Bedmar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Jim\u00e9nez-Navarro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,8]]},"reference":[{"key":"2662_CR1","doi-asserted-by":"publisher","first-page":"433","DOI":"10.1016\/j.jcmg.2018.06.014","volume":"12","author":"Y Topilsky","year":"2019","unstructured":"Topilsky Y, Maltais S, Medina Inojosa J et al (2019) Burden of tricuspid regurgitation in patients diagnosed in the community setting. 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