{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T06:52:52Z","timestamp":1791355972265,"version":"4.3.1"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,10,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">The prognostic significance of right heart remodeling (RHR) in patients with secondary tricuspid regurgitation (STR) who do not meet guideline\u2010based indications for tricuspid valve surgery remains uncertain. We evaluated whether advanced markers of RHR are associated with outcomes in medically managed patients with significant STR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">We retrospectively included 755 patients with significant STR (age 75\u00b112\u2009years). Patients were stratified into 3 groups: Group 1, no current surgical indication (n=519); Group 2, meeting Class I\/IIa guideline criteria (n=144); and Group 3, deemed inoperable (n=92). RHR markers included right atrial volume index, right ventricular end\u2010diastolic volume index, forward stroke volume\/right ventricular end\u2010systolic volume ratio, and effective right ventricular ejection fraction. The primary end point was a composite of all\u2010cause mortality or heart failure hospitalization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Group 1 patients had less severe STR and less advanced right ventricular remodeling than Groups 2 and 3. Over a median follow\u2010up of 24 months (interquartile range, 11\u201334), 330 primary events occurred; 64 patients underwent tricuspid valve intervention. In Group 1, 30\u2010month event\u2010free survival was 71\u00b14% with no RHR markers, 65\u00b13% with 1 or 2 markers, and 33\u00b19% with \u22653 markers (adjusted hazard ratio [aHR], 2.76 [95% CI, 1.74\u20134.37];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001). Patients in Group 1 with \u22653 RHR markers had event rates comparable to Group 2 (aHR, 2.79 [95% CI, 1.94\u20134.02];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001) and Group 3 (aHR, 4.08 [95% CI, 2.73\u20136.09];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Among patients with significant STR without surgical indications, \u22653 markers of RHR identify a high\u2010risk phenotype with outcomes similar to those meeting surgical criteria or considered inoperable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.126.049040","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T04:28:41Z","timestamp":1790310521000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Right Heart Remodeling Redefines Risk in Significant Secondary Tricuspid Regurgitation Without Indication for Intervention"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3004-2100","authenticated-orcid":false,"given":"Michele","family":"Tomaselli","sequence":"first","affiliation":[{"name":"Istituto Auxologico Italiano, IRCCS","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4040-6112","authenticated-orcid":false,"given":"Marco","family":"Penso","sequence":"additional","affiliation":[{"name":"Istituto Auxologico Italiano, IRCCS","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0379-3283","authenticated-orcid":false,"given":"Luigi P.","family":"Badano","sequence":"additional","affiliation":[{"name":"Istituto Auxologico Italiano, IRCCS","place":["Milan, Italy"]},{"name":"University of Milano\u2010Bicocca","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyu","family":"Kim","sequence":"additional","affiliation":[{"name":"Severance Cardiovascular Hospital, Yonsei University College of Medicine","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2364-7929","authenticated-orcid":false,"given":"Daniela N.","family":"Radu","sequence":"additional","affiliation":[{"name":"Istituto Auxologico Italiano, IRCCS","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1103-2203","authenticated-orcid":false,"given":"Paolo","family":"Springhetti","sequence":"additional","affiliation":[{"name":"Istituto Auxologico Italiano, IRCCS","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5361-3076","authenticated-orcid":false,"given":"Alexandra","family":"Buta","sequence":"additional","affiliation":[{"name":"\u2018Prof. Dr. C.C. Iliescu\u2019 Emergency Institute for Cardiovascular Diseases","place":["Bucharest, Romania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0500-0312","authenticated-orcid":false,"given":"Diana R.","family":"H\u0103d\u0103reanu","sequence":"additional","affiliation":[{"name":"University of Medicine and Pharmacy of Craiova","place":["Craiova, Romania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4981-3304","authenticated-orcid":false,"given":"Geu\u2010Ru","family":"Hong","sequence":"additional","affiliation":[{"name":"Severance Cardiovascular Hospital, Yonsei University College of Medicine","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3003-6499","authenticated-orcid":false,"given":"Sergio","family":"Caravita","sequence":"additional","affiliation":[{"name":"Istituto Auxologico Italiano, IRCCS","place":["Milan, Italy"]},{"name":"Information and Production Engineering, University of Bergamo","place":["Dalmine (BG), Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3472-4851","authenticated-orcid":false,"given":"Claudia","family":"Baratto","sequence":"additional","affiliation":[{"name":"Istituto Auxologico Italiano, IRCCS","place":["Milan, Italy"]},{"name":"Information and Production Engineering, University of Bergamo","place":["Dalmine (BG), Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brigida","family":"Napolitano","sequence":"additional","affiliation":[{"name":"University Federico II","place":["Naples, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2728-5023","authenticated-orcid":false,"given":"Giorgia","family":"Benzoni","sequence":"additional","affiliation":[{"name":"Istituto Auxologico Italiano, IRCCS","place":["Milan, Italy"]},{"name":"University of Milano\u2010Bicocca","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Clement","sequence":"additional","affiliation":[{"name":"Grigore T. 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