{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T22:26:31Z","timestamp":1793831191360,"version":"4.6.1"},"reference-count":87,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Tricuspid regurgitation (TR) rarely exists as an isolated condition and is most frequently secondary due to heart failure (HF), or atrial fibrillation, with prevalent extracardiac comorbidities. Morphological assessment of the anatomy and severity of TR, together with evaluation of symptoms, currently drives interventional approaches, yet a more holistic integration of causal and contributing comorbid conditions might further improve outcomes. The present review explores such a pathophysiology-driven holistic approach to interpret functional changes and symptomatic burden in patients with TR. It focuses on acknowledging the dynamic nature of TR, but most importantly, the bidirectional crosstalk between TR and HF, as well as other organ systems that might drive symptoms and prognosis, but also TR progression. Assessment of TR is ideally performed after optimizing the treatment of interfering comorbidities and correcting volume overload to isolate the true effects of the TR itself. Invasive haemodynamic assessment, portal vein Doppler, and liver stiffness measurements may offer useful information in clinical decision-making. When TR is identified as the primary driver of disease, or if it is strongly interacting with concomitant diseases, more aggressive therapeutic approaches may be pursued. In contrast, when it is more a consequence of the underlying HF, the right expectations in terms of symptomatic improvement and prognosis should be set. This framework may help to identify patients who are the most likely to benefit from TR interventions, while acknowledging the complexity of their clinical picture in the context of HF.<\/jats:p>","DOI":"10.1093\/ejhf\/xuag226","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T11:36:40Z","timestamp":1784029000000},"page":"664-675","source":"Crossref","is-referenced-by-count":1,"title":["Rethinking tricuspid regurgitation in heart failure\u2014a pathophysiology-based holistic approach for individualized patient management"],"prefix":"10.1093","volume":"28","author":[{"given":"Karl-Patrik","family":"Kresoja","sequence":"first","affiliation":[{"name":"Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz , Langenbeckstr. 1, Mainz 55131 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"Stolz","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik I, LMU Klinikum, LMU M\u00fcnchen , Munich ,","place":["Germany"]},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance , Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7609-6297","authenticated-orcid":false,"given":"Antonio","family":"Cannata","sequence":"additional","affiliation":[{"name":"Faculty of Life Science, British Heart Foundation Centre of Research Excellence, School of Cardiovascular Medicine, King's College London , London ,","place":["UK"]},{"name":"Cardiology Department, King's College Hospital NHS Foundation Trust , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl-Philipp","family":"Rommel","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz , Langenbeckstr. 1, Mainz 55131 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirjam","family":"Wild","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, Faculty of Medicine, Medical Center, University Heart Center, University of Freiburg , Hugstetter Str. 55, Freiburg 79106 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edoardo","family":"Zancanaro","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Mass General Brigham, Brigham and Women's Hospital, Harvard Medical School , Boston, MA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrike","family":"Arfsten","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna , Waehringer Guertel 18-20, Vienna 1090 ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8082-6472","authenticated-orcid":false,"given":"Christian","family":"Besler","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, Faculty of Medicine, Medical Center, University Heart Center, University of Freiburg , Hugstetter Str. 55, Freiburg 79106 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3027-1771","authenticated-orcid":false,"given":"Guillaume","family":"Bonnet","sequence":"additional","affiliation":[{"name":"Medico-Surgical Department, Haut-L\u00e9v\u00eaque Cardiological Hospital; Bordeaux University Hospital , Pessac 33600 ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niklas","family":"Schofer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Electrophysiology, Pneumology and General Internal Medicine, Friedrich-Ebert-Krankenhaus Neum\u00fcnster , Neum\u00fcnster ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"St\u00f6hr","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital Frankfurt , Frankfurt ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Sticchi","sequence":"additional","affiliation":[{"name":"Cardio Center, University of Pisa , Lungarno Antonio Pacinotti, 43, Pisa, Pisa 56126 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirjam","family":"Kessler","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Innere Medizin II, Universit\u00e4res Herzzentrum Ulm , Ulm ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Rafflenbeul","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Sch\u00f6n Klinik Hamburg Eilbek , Hamburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederik H","family":"Verbrugge","sequence":"additional","affiliation":[{"name":"Centre for Cardiovascular Diseases, University Hospital Brussels , Laarbeeklaan 101, Jette 1090 ,","place":["Belgium"]},{"name":"Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel , Brussels ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,15]]},"reference":[{"key":"2026102813071993200_xuag226-B1","doi-asserted-by":"publisher","first-page":"102493","DOI":"10.1016\/j.jchf.2025.04.008","article-title":"Current evidence on tricuspid regurgitation interventions in heart failure","volume":"13","author":"Hahn","year":"2025","journal-title":"JACC Heart Fail"},{"key":"2026102813071993200_xuag226-B2","doi-asserted-by":"publisher","first-page":"645","DOI":"10.4244\/EIJ-D-17-01136","article-title":"Patient selection, echocardiographic screening and treatment strategies for interventional tricuspid repair using the edge-to-edge repair technique","volume":"14","author":"Hausleiter","year":"2018","journal-title":"EuroIntervention"},{"key":"2026102813071993200_xuag226-B3","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1016\/j.jacc.2024.10.071","article-title":"Transcatheter tricuspid valve replacement","volume":"85","author":"Hausleiter","year":"2025","journal-title":"J Am Coll Cardiol"},{"key":"2026102813071993200_xuag226-B4","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1002\/ejhf.3106","article-title":"Epidemiology, pathophysiology, diagnosis and management of chronic right-sided heart failure and tricuspid regurgitation. 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