{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T23:53:32Z","timestamp":1783727612691,"version":"3.55.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2012,8,1]],"date-time":"2012-08-01T00:00:00Z","timestamp":1343779200000},"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":[[2012,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The prognostic role of tricuspid regurgitation (TR) associated with organic left-sided valvular heart disease is well known. However, no data are available regarding the prognostic value of functional TR (FTR) in patients with functional mitral regurgitation (FMR) and left ventricular (LV) dysfunction. The purpose of this study was to evaluate the prognostic role of FTR for occurrence of heart failure (HF) and mortality in patients with FMR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We enrolled 373 consecutive patients (mean age 68 \u00b111 years) with LV dysfunction and at least mild FMR and with or without FTR, both quantitated by echocardiography. The median follow-up was 32 months (range 1\u2013120 months); 132 (35.4%) and 97 patients developed HF or died, respectively. The incidence of HF at 3 and 6 years was 36 \u00b12% and 55 \u00b14%, respectively. Moderate to severe FTR [hazard ratio (HR) 1.4, 95% confidence interval (CI) 1.1\u20132.1, P = 0.01) was an independent determinant of HF. The incidence of HF was 41 \u00b15, 46 \u00b17, 57 \u00b17, and 65 \u00b18% for patients without, and with mild, moderate, and severe FTR respectively (P = 0.03). At 3 and 6 years the survival free of all-cause mortality was 77.5 \u00b12% and 60 \u00b13%, respectively. Moderate to severe FTR (HR 1.6, 95% CI 1.2\u20132.1, P = 0.01) was an independent determinant of overall mortality. At 6 years, survival free of all-cause mortality was 69 \u00b12.5, 67 \u00b12.1, 51 \u00b12.5, and 40 \u00b14.8% for patients without, and with mild, moderate, and severe FTR, respectively (P = 0.004).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Moderate or more FTR is independently associated with worse survival and a high incidence of HF episodes in patients with FMR.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurjhf\/hfs063","type":"journal-article","created":{"date-parts":[[2012,5,2]],"date-time":"2012-05-02T20:36:48Z","timestamp":1335991008000},"page":"902-908","source":"Crossref","is-referenced-by-count":64,"title":["Impact of Functional Tricuspid Regurgitation on Heart Failure and Death in Patients with Functional Mitral Regurgitation and Left Ventricular Dysfunction"],"prefix":"10.1093","volume":"14","author":[{"given":"Eustachio","family":"Agricola","sequence":"first","affiliation":[{"name":"Division of Noninvasive Cardiology, San Raffaele Hospital, IRCCS , Via Olgettina 60, 20132, Milano ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Stella","sequence":"additional","affiliation":[{"name":"Division of Noninvasive Cardiology, San Raffaele Hospital, IRCCS , Via Olgettina 60, 20132, Milano ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariangela","family":"Gullace","sequence":"additional","affiliation":[{"name":"Division of Noninvasive Cardiology, San Raffaele Hospital, IRCCS , Via Olgettina 60, 20132, Milano ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giacomo","family":"Ingallina","sequence":"additional","affiliation":[{"name":"Division of Noninvasive Cardiology, San Raffaele Hospital, IRCCS , Via Olgettina 60, 20132, Milano ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rossella","family":"D'Amato","sequence":"additional","affiliation":[{"name":"Division of Noninvasive Cardiology, San Raffaele Hospital, IRCCS , Via Olgettina 60, 20132, Milano ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Slavich","sequence":"additional","affiliation":[{"name":"Division of Noninvasive Cardiology, San Raffaele Hospital, IRCCS , Via Olgettina 60, 20132, Milano ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Oppizzi","sequence":"additional","affiliation":[{"name":"Division of Noninvasive Cardiology, San Raffaele Hospital, IRCCS , Via Olgettina 60, 20132, Milano ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco Bruno","family":"Ancona","sequence":"additional","affiliation":[{"name":"Division of Noninvasive Cardiology, San Raffaele Hospital, IRCCS , Via Olgettina 60, 20132, Milano ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Margonato","sequence":"additional","affiliation":[{"name":"Division of Noninvasive Cardiology, San Raffaele Hospital, IRCCS , Via Olgettina 60, 20132, Milano ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2014,2,18]]},"reference":[{"key":"2026011921173153400_ejhfhfs063-bib-0001","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":"2026011921173153400_ejhfhfs063-bib-0002","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/S0894-7317(97)70086-5","article-title":"Echocardiographic assessment of mitral stenosis and its associated valvular lesions in 205 patients and lack of association with mitral valve prolapse","volume":"10","author":"Sagie","year":"1997","journal-title":"J Am Soc Echocardiogr"},{"key":"2026011921173153400_ejhfhfs063-bib-0003","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1016\/j.jacc.2008.09.048","article-title":"Tricuspid regurgitation in mitral valve disease incidence, prognostic implications, mechanism, and management","volume":"53","author":"Shiran","year":"2009","journal-title":"J Am Coll Cardiol"},{"key":"2026011921173153400_ejhfhfs063-bib-0004","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1177\/0003319707302495","article-title":"Outcome of significant functional tricuspid regurgitation late after mitral valve replacement for predominant rheumatic mitral stenosis","volume":"58","author":"Boyaci","year":"2007","journal-title":"Angiology"},{"key":"2026011921173153400_ejhfhfs063-bib-0005","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1016\/j.jtcvs.2003.11.048","article-title":"Late incidence and predictors of persistent or recurrent heart failure in patients with mitral prosthetic valves","volume":"128","author":"Ruel","year":"2004","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2026011921173153400_ejhfhfs063-bib-0006","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1016\/j.jtcvs.2003.11.019","article-title":"Tricuspid valve repair: durability and risk factors for failure","volume":"127","author":"McCarthy","year":"2004","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2026011921173153400_ejhfhfs063-bib-0007","first-page":"353","article-title":"Progression of isolated tricuspid regurgitation late after mitral valve surgery for rheumatic mitral valve disease","volume":"11","author":"Izumi","year":"2002","journal-title":"J Heart Valve Dis"},{"key":"2026011921173153400_ejhfhfs063-bib-0008","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":"2026011921173153400_ejhfhfs063-bib-0009","doi-asserted-by":"crossref","first-page":"I453","DOI":"10.1161\/CIRCULATIONAHA.104.524421","article-title":"Progression of tricuspid regurgitation after repaired functional ischemic mitral regurgitation","volume":"112","author":"Matsunaga","year":"2005","journal-title":"Circulation"},{"key":"2026011921173153400_ejhfhfs063-bib-0010","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1016\/j.ejcts.2008.01.011","article-title":"Evolution of tricuspid regurgitation after mitral valve repair for functional mitral regurgitation in dilated cardiomyopathy","volume":"33","author":"De Bonis","year":"2008","journal-title":"Eur J Cardiothorac Surg"},{"key":"2026011921173153400_ejhfhfs063-bib-0011","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1016\/S0735-1097(99)00608-7","article-title":"The prognostic implications of renal insufficiency in asymptomatic and symptomatic patients with left ventricular systolic dysfunction","volume":"35","author":"Dries","year":"2000","journal-title":"J Am Coll Cardiol"},{"key":"2026011921173153400_ejhfhfs063-bib-0012","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1093\/ejechocard\/jeq031","article-title":"European Association of Echocardiography. European Association of Echocardiography recommendations for the assessment of valvular regurgitation. Part 2: mitral and tricuspid regurgitation (native valve disease)","volume":"11","author":"Lancellotti","year":"2010","journal-title":"Eur J Echocardiogr"},{"key":"2026011921173153400_ejhfhfs063-bib-0013","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1016\/S0002-9149(98)01064-9","article-title":"Prevalence and clinical determinants of mitral, tricuspid, and aortic regurgitation (the Framingham Heart Study)","volume":"83","author":"Singh","year":"1999","journal-title":"Am J Cardiol"},{"key":"2026011921173153400_ejhfhfs063-bib-0014","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1016\/j.echo.2010.05.010","article-title":"Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography","volume":"23","author":"Rudski","year":"2010","journal-title":"J Am Soc Echocardiogr"},{"key":"2026011921173153400_ejhfhfs063-bib-0015","doi-asserted-by":"crossref","first-page":"1527","DOI":"10.1053\/euhj.2001.2783","article-title":"Task Force for the Diagnosis and Treatment of Chronic Heart Failure, European Society of Cardiology. Guidelines for the diagnosis and treatment of chronic heart failure","volume":"22","author":"Remme","year":"2001","journal-title":"Eur Heart J"},{"key":"2026011921173153400_ejhfhfs063-bib-0016","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1093\/eurjhf\/hfq118","article-title":"Congestion in chronic systolic heart failure is related to renal dysfunction and increased mortality","volume":"12","author":"Damman","year":"2010","journal-title":"Eur J Heart Fail"},{"key":"2026011921173153400_ejhfhfs063-bib-0017","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1093\/eurjhf\/hfq195","article-title":"Central venous pressure and impaired renal function in patients with acute heart failure","volume":"13","author":"Uthoff","year":"2011","journal-title":"Eur J Heart Fail"},{"key":"2026011921173153400_ejhfhfs063-bib-0018","doi-asserted-by":"crossref","first-page":"1759","DOI":"10.1161\/01.CIR.103.13.1759","article-title":"Ischemic mitral regurgitation: long-term outcome and prognostic implications with quantitative Doppler assessment","volume":"103","author":"Grigioni","year":"2001","journal-title":"Circulation"},{"key":"2026011921173153400_ejhfhfs063-bib-0019","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1016\/j.jacc.2004.10.030","article-title":"Contribution of ischemic mitral regurgitation to congestive heart failure after myocardial infarction","volume":"45","author":"Grigioni","year":"2005","journal-title":"J Am Coll Cardiol"},{"key":"2026011921173153400_ejhfhfs063-bib-0020","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1161\/01.CIR.0000151097.30779.04","article-title":"Heart failure and death after myocardial infarction in the community: the emerging role of mitral regurgitation","volume":"111","author":"Bursi","year":"2005","journal-title":"Circulation"},{"key":"2026011921173153400_ejhfhfs063-bib-0021","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1093\/eurjhf\/hfp051","article-title":"Long-term prognosis of medically treated patients with functional mitral regurgitation and left ventricular dysfunction","volume":"11","author":"Agricola","year":"2009","journal-title":"Eur J Heart Fail"},{"key":"2026011921173153400_ejhfhfs063-bib-0022","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1016\/j.ijcard.2010.10.096","article-title":"Non-ischemic dilated cardiopathy: prognostic value of functional mitral regurgitation","volume":"146","author":"Agricola","year":"2011","journal-title":"Int J Cardiol"},{"key":"2026011921173153400_ejhfhfs063-bib-0023","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1016\/j.ahj.2008.01.003","article-title":"Plasma N-terminal protype-B natriuretic peptide levels in risk assessment of patients with mitral regurgitation secondary to ischemic and nonischemic dilated cardiomyopathy","volume":"155","author":"Dini","year":"2008","journal-title":"Am Heart J"},{"key":"2026011921173153400_ejhfhfs063-bib-0024","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1016\/j.ejheart.2008.04.003","article-title":"Prognostic significance of tricuspid annular motion and plasma NT-proBNP in patients with heart failure and moderate-to-severe functional mitral regurgitation","volume":"10","author":"Dini","year":"2008","journal-title":"Eur J Heart Fail"},{"key":"2026011921173153400_ejhfhfs063-bib-0025","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":"2026011921173153400_ejhfhfs063-bib-0026","doi-asserted-by":"crossref","first-page":"902","DOI":"10.1016\/j.echo.2006.01.014","article-title":"Severe tricuspid regurgitation shows significant impact in the relationship among peak systolic tricuspid annular velocity, tricuspid annular plane systolic excursion, and right ventricular ejection fraction","volume":"19","author":"Hsiao","year":"2006","journal-title":"J Am Soc Echocardiogr"}],"container-title":["European Journal of Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1093%2Feurjhf%2Fhfs063","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1093%2Feurjhf%2Fhfs063","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1093\/eurjhf\/hfs063","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1093\/eurjhf\/hfs063","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/eurjhf\/article-pdf\/14\/8\/902\/66442466\/eurjhf_14_8_902.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eurjhf\/article-pdf\/14\/8\/902\/66442466\/eurjhf_14_8_902.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T02:22:59Z","timestamp":1768875779000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eurjhf\/article\/14\/8\/902\/8428918"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,8,1]]},"references-count":26,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2014,2,18]]},"published-print":{"date-parts":[[2012,8,1]]}},"URL":"https:\/\/doi.org\/10.1093\/eurjhf\/hfs063","relation":{},"ISSN":["1388-9842","1879-0844"],"issn-type":[{"value":"1388-9842","type":"print"},{"value":"1879-0844","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2012,8]]},"published":{"date-parts":[[2012,8,1]]}}}