{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T22:10:13Z","timestamp":1790547013848,"version":"4.1.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2022,5,2]],"date-time":"2022-05-02T00:00:00Z","timestamp":1651449600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000860","name":"European Society of Cardiology","doi-asserted-by":"publisher","award":["App000064741"],"award-info":[{"award-number":["App000064741"]}],"id":[{"id":"10.13039\/501100000860","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000860","name":"European Society of Cardiology","doi-asserted-by":"publisher","award":["App000080404"],"award-info":[{"award-number":["App000080404"]}],"id":[{"id":"10.13039\/501100000860","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,7,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>This study evaluated the prognostic value of staging right heart failure in patients with significant tricuspid regurgitation (TR) undergoing tricuspid valve (TV) surgery.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Patients with significant TR who underwent TV surgery were divided into 4 right heart failure stages according to the presence of right ventricular (RV) dysfunction and clinical signs of right heart failure: stage 1 was defined as no RV dysfunction and no signs of right heart failure; stage 2 indicated RV dysfunction without signs of right heart failure; stage 3 included RV dysfunction and signs of right heart failure; and stage 4 was defined as RV dysfunction and refractory signs of right heart failure at rest.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>A total of 278 patients [mean age 64 (12), 49% males] were included, of whom 34 (12%) patients were classified as stages 1 and 2, 141 (51%) as stage 3 and 103 (37%) as stage 4 right heart failure. The majority of patients (91%) had TV surgery concomitant to left-sided valve surgery or coronary artery bypass grafting and 95% underwent TV annuloplasty. Cumulative survival rates were 89%, 78% and 61% at 1\u2009month, 1 year and 5 years, respectively. Stages 1 and 2 and stage 3 were independently associated with better survival compared to stage 4 (hazard ratio: 0.391 [95% confidence interval: 0.186\u20130.823] and 0.548 [95% confidence interval: 0.369\u20130.813], respectively).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Patients with significant TR undergoing TV surgery and diagnosed without advanced right heart failure have better survival as compared to patients with right heart failure.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezac290","type":"journal-article","created":{"date-parts":[[2022,4,28]],"date-time":"2022-04-28T19:16:31Z","timestamp":1651173391000},"source":"Crossref","is-referenced-by-count":27,"title":["Staging right heart failure in patients with tricuspid regurgitation undergoing tricuspid surgery"],"prefix":"10.1093","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6294-7668","authenticated-orcid":false,"given":"Xavier","family":"Galloo","sequence":"first","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Centre , Leiden, Netherlands"},{"name":"Department of Cardiology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel) , Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9745-5498","authenticated-orcid":false,"given":"Jan","family":"Stassen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Centre , Leiden, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8258-8802","authenticated-orcid":false,"given":"Steele C","family":"Butcher","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Centre , Leiden, Netherlands"},{"name":"Department of Cardiology, Royal Perth Hospital , Perth, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5474-0555","authenticated-orcid":false,"given":"Maria Chiara","family":"Meucci","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Centre , Leiden, Netherlands"},{"name":"Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of the Sacred Heart , Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlieke F","family":"Dietz","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Centre , Leiden, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5019-0354","authenticated-orcid":false,"given":"Bart J A","family":"Mertens","sequence":"additional","affiliation":[{"name":"Department of Bioinformatics, Bioinformatics Centre of Expertise, Leiden University Medical Centre , Leiden, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3904-1382","authenticated-orcid":false,"given":"Edgard A","family":"Prihadi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Centre , Leiden, Netherlands"},{"name":"Hartcentrum, Ziekenhuis Netwerk Antwerpen (ZNA) Middelheim , Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1693-7968","authenticated-orcid":false,"given":"Pieter","family":"van der Bijl","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Centre , Leiden, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"Ajmone Marsan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Centre , Leiden, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4504-6235","authenticated-orcid":false,"given":"Jerry","family":"Braun","sequence":"additional","affiliation":[{"name":"Department of Cardio-Thoracic Surgery, Leiden University Medical Centre , Leiden, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7368-0500","authenticated-orcid":false,"given":"Jeroen J","family":"Bax","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Centre , Leiden, Netherlands"},{"name":"Heart Centre, University of Turku and Turku University Hospital , Turku, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9841-2737","authenticated-orcid":false,"given":"Victoria","family":"Delgado","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Centre , Leiden, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,5,2]]},"reference":[{"key":"2022122414012475400_ezac290-B1","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1016\/j.jacc.2003.09.036","article-title":"Impact of tricuspid regurgitation on long-term survival","volume":"43","author":"Nath","year":"2004","journal-title":"J Am Coll Cardiol"},{"key":"2022122414012475400_ezac290-B2","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1016\/j.jcmg.2018.06.014","article-title":"Burden of tricuspid regurgitation in patients diagnosed in the community setting","volume":"12","author":"Topilsky","year":"2019","journal-title":"JACC Cardiovasc Imaging"},{"key":"2022122414012475400_ezac290-B3","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1093\/ejcts\/ezab389","article-title":"2021 ESC\/EACTS Guidelines for the management of valvular heart disease","volume":"60","author":"Vahanian","year":"2021","journal-title":"Eur J Cardiothorac Surg"},{"key":"2022122414012475400_ezac290-B4","first-page":"e35","article-title":"2020 ACC\/AHA Guideline for the management of patients with valvular heart disease: executive summary: a report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"143","author":"Otto","year":"2021","journal-title":"Circulation"},{"key":"2022122414012475400_ezac290-B5","doi-asserted-by":"crossref","first-page":"2331","DOI":"10.1016\/j.jacc.2015.04.011","article-title":"Functional tricuspid regurgitation: a need to revise our understanding","volume":"65","author":"Dreyfus","year":"2015","journal-title":"J Am Coll Cardiol"},{"key":"2022122414012475400_ezac290-B6","doi-asserted-by":"crossref","first-page":"2633","DOI":"10.1016\/j.jacc.2014.09.062","article-title":"Right ventricular dysfunction, but not tricuspid regurgitation, is associated with outcome late after left heart valve procedure","volume":"64","author":"Kammerlander","year":"2014","journal-title":"J Am Coll Cardiol"},{"key":"2022122414012475400_ezac290-B7","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1161\/CIRCULATIONAHA.119.039630","article-title":"Prognostic implications of right ventricular remodeling and function in patients with significant secondary tricuspid regurgitation","volume":"140","author":"Dietz","year":"2019","journal-title":"Circulation"},{"key":"2022122414012475400_ezac290-B8","doi-asserted-by":"crossref","first-page":"1717","DOI":"10.1161\/CIRCULATIONAHA.107.653584","article-title":"Right ventricular function in cardiovascular disease, part II: pathophysiology, clinical importance, and management of right ventricular failure","volume":"117","author":"Haddad","year":"2008","journal-title":"Circulation"},{"key":"2022122414012475400_ezac290-B9","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1002\/ejhf.1029","article-title":"Right heart dysfunction and failure in heart failure with preserved ejection fraction: mechanisms and management. Position statement on behalf of the Heart Failure Association of the European Society of Cardiology","volume":"20","author":"Gorter","year":"2018","journal-title":"Eur J Heart Fail"},{"key":"2022122414012475400_ezac290-B10","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1016\/j.jchf.2020.02.008","article-title":"Prognostic implications of staging right heart failure in patients with significant secondary tricuspid regurgitation","volume":"8","author":"Dietz","year":"2020","journal-title":"JACC Heart Fail"},{"key":"2022122414012475400_ezac290-B11","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/j.echo.2017.01.007","article-title":"Recommendations for noninvasive evaluation of native valvular regurgitation: a report from the American Society of Echocardiography developed in collaboration with the Society for Cardiovascular Magnetic Resonance","volume":"30","author":"Zoghbi","year":"2017","journal-title":"J Am Soc Echocardiogr"},{"key":"2022122414012475400_ezac290-B12","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.echo.2014.10.003","article-title":"Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging","volume":"28","author":"Lang","year":"2015","journal-title":"J Am Soc Echocardiogr"},{"key":"2022122414012475400_ezac290-B13","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1093\/ehjci\/jet105","article-title":"Recommendations for the echocardiographic assessment of native valvular regurgitation: an executive summary from the European Association of Cardiovascular Imaging","volume":"14","author":"Lancellotti","year":"2013","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2022122414012475400_ezac290-B14","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1016\/j.ejcts.2007.12.055","article-title":"Guidelines for reporting mortality and morbidity after cardiac valve interventions","volume":"33","author":"Akins","year":"2008","journal-title":"Eur J Cardiothorac Surg"},{"key":"2022122414012475400_ezac290-B15","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1136\/heart.83.1.116","article-title":"Cardiac valve surgery in the octogenarian","volume":"83","author":"Pr\u00eatre","year":"2000","journal-title":"Heart"},{"key":"2022122414012475400_ezac290-B16","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1093\/eurheartj\/ehv598","article-title":"Gender in cardiovascular diseases: impact on clinical manifestations, management, and outcomes","volume":"37","author":"Regitz-Zagrosek","year":"2016","journal-title":"Eur Heart J"},{"key":"2022122414012475400_ezac290-B17","doi-asserted-by":"crossref","first-page":"1672","DOI":"10.1161\/CIRCULATIONAHA.109.849448","article-title":"Determinants of surgical outcome in patients with isolated tricuspid regurgitation","volume":"120","author":"Kim","year":"2009","journal-title":"Circulation"},{"key":"2022122414012475400_ezac290-B18","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1016\/j.kint.2019.06.025","article-title":"Chronic kidney disease and valvular heart disease: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference","volume":"96","author":"Marwick","year":"2019","journal-title":"Kidney Int"},{"key":"2022122414012475400_ezac290-B19","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/j.athoracsur.2004.06.057","article-title":"Secondary tricuspid regurgitation or dilatation: which should be the criteria for surgical repair?","volume":"79","author":"Dreyfus","year":"2005","journal-title":"Ann Thorac Surg"},{"key":"2022122414012475400_ezac290-B20","doi-asserted-by":"crossref","first-page":"960","DOI":"10.1136\/heartjnl-2013-304673","article-title":"Significant lead-induced tricuspid regurgitation is associated with poor prognosis at long-term follow-up","volume":"100","author":"H\u00f6ke","year":"2014","journal-title":"Heart"},{"key":"2022122414012475400_ezac290-B21","doi-asserted-by":"crossref","first-page":"1431","DOI":"10.1016\/j.jtcvs.2010.05.050","article-title":"Tricuspid annuloplasty prevents right ventricular dilatation and progression of tricuspid regurgitation in patients with tricuspid annular dilatation undergoing mitral valve repair","volume":"141","author":"Van de Veire","year":"2011","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2022122414012475400_ezac290-B22","doi-asserted-by":"crossref","first-page":"1546","DOI":"10.1016\/j.athoracsur.2013.06.031","article-title":"Trends and outcomes of tricuspid valve surgery in North America: an analysis of more than 50,000 patients from the Society of Thoracic Surgeons database","volume":"96","author":"Kilic","year":"2013","journal-title":"Ann Thorac Surg"},{"key":"2022122414012475400_ezac290-B23","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1016\/j.jtcvs.2011.07.004","article-title":"Tricuspid valve surgery: the past 10 years from the Nationwide Inpatient Sample (NIS) database","volume":"143","author":"Vassileva","year":"2012","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2022122414012475400_ezac290-B24","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1055\/s-0035-1551676","article-title":"Cardiac surgery in Germany during 2014: a report on behalf of the German Society for Thoracic and Cardiovascular Surgery","volume":"63","author":"Beckmann","year":"2015","journal-title":"Thorac Cardiovasc Surg"},{"key":"2022122414012475400_ezac290-B25","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1136\/heartjnl-2012-302856","article-title":"Surgical outcomes of severe tricuspid regurgitation: predictors of adverse clinical outcomes","volume":"99","author":"Kim","year":"2013","journal-title":"Heart"},{"key":"2022122414012475400_ezac290-B26","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1055\/s-0037-1604450","article-title":"Comparison of outcomes of tricuspid valve surgery in patients with reduced and normal right ventricular function","volume":"65","author":"Subbotina","year":"2017","journal-title":"Thorac Cardiovasc Surg"},{"key":"2022122414012475400_ezac290-B27","doi-asserted-by":"crossref","first-page":"2002","DOI":"10.1016\/S0140-6736(19)32600-5","article-title":"Transcatheter edge-to-edge repair for reduction of tricuspid regurgitation: 6-month outcomes of the TRILUMINATE single-arm study","volume":"394","author":"Nickenig","year":"2019","journal-title":"Lancet"},{"key":"2022122414012475400_ezac290-B28","doi-asserted-by":"crossref","first-page":"1905","DOI":"10.1016\/j.jacc.2019.01.062","article-title":"6-Month outcomes of tricuspid valve reconstruction for patients with severe tricuspid regurgitation","volume":"73","author":"Nickenig","year":"2019","journal-title":"J Am Coll Cardiol"},{"key":"2022122414012475400_ezac290-B29","doi-asserted-by":"crossref","first-page":"1438","DOI":"10.1016\/j.jcin.2019.04.038","article-title":"Long-term outcomes of the FORMA transcatheter tricuspid valve repair system for the treatment of severe tricuspid regurgitation: insights from the first-in-human experience","volume":"12","author":"Asmarats","year":"2019","journal-title":"JACC Cardiovasc Interv"},{"key":"2022122414012475400_ezac290-B30","doi-asserted-by":"crossref","first-page":"2488","DOI":"10.1016\/j.jcin.2019.09.046","article-title":"Compassionate use of the PASCAL transcatheter valve repair system for severe tricuspid regurgitation: a multicenter, observational, first-in-human experience","volume":"12","author":"Fam","year":"2019","journal-title":"JACC Cardiovasc Interv"}],"container-title":["European Journal of Cardio-Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ejcts\/advance-article-pdf\/doi\/10.1093\/ejcts\/ezac290\/43517238\/ezac290.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejcts\/article-pdf\/62\/2\/ezac290\/48411163\/ezac290.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejcts\/article-pdf\/62\/2\/ezac290\/48411163\/ezac290.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,24]],"date-time":"2022-12-24T14:01:43Z","timestamp":1671890503000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejcts\/article\/doi\/10.1093\/ejcts\/ezac290\/6576630"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,2]]},"references-count":30,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022,7,11]]}},"URL":"https:\/\/doi.org\/10.1093\/ejcts\/ezac290","relation":{},"ISSN":["1873-734X"],"issn-type":[{"value":"1873-734X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,8,1]]},"published":{"date-parts":[[2022,5,2]]},"article-number":"ezac290"}}