{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T16:47:06Z","timestamp":1750438026191},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,3,12]],"date-time":"2024-03-12T00:00:00Z","timestamp":1710201600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,3,12]],"date-time":"2024-03-12T00:00:00Z","timestamp":1710201600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"West China Hospital \u201c1\u00b73\u00b75\u201d Discipline of Excellence Project- \u201cMechanisms of aortic stenosis and the clinical applications\u201d"},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["82170375 and 82102129","82170375 and 82102129"],"award-info":[{"award-number":["82170375 and 82102129","82170375 and 82102129"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Cardiovasc Disord"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Tricuspid regurgitation (TR) is a prevalent disease that triggers systemic pathological changes including cardiac, respiratory, hepatic and digestive, hematopoietic, renal and skin issues. The burden of extra-cardiac manifestations has not been well described in TR patients and the clinical impact is unknown.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Patients with severe or more-than-severe TR during hospitalization, who did not have any previous cardiac procedures, hemodynamically significant congenital heart disease or concomitant severe aortic or mitral valve disease, were retrospectively analyzed. Pre-specified criteria and diagnosis of baseline characteristics were used to evaluate the presence of extra-cardiac manifestations secondary to TR after excluding comorbidities that may also lead to corresponding abnormalities. Extra-cardiac involvements encompass respiratory, hepatic and, digestive, renal, hematopoietic and dermatic system. Staging criteria are defined as no extra-cardiac system involvement in Stage 1, one in Stage 2, at least two extra-cardiac involvements in Stage 3 and any end-stage organ failure in Stage 4. A telephone follow-up was conducted to record the composite endpoint namely all-cause death or cardiac rehospitalization after the index hospitalization.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A total of 258 patients were identified with a median age of 73 (interquartile range [IQR]: 62\u201383) years and 52.3% were female. Severe TR and more-than-severe TR patients accounted for 92.6% and 7.4% of the cohort. There were 20.5%, 27.5%, 37.6% and 14.3% of patients from Stage 1 to 4 respectively. The follow-up time was at a median of 251 (IQR: 183\u2013324) days. TR Patients in Stage 3&amp;4 were at an increased risk with borderline statistical significance to experience the composite endpoint compared to patients in Stage 1&amp;2 (odds ratio [OR] 1.9, 95% confidence interval [CI] 1.0 to 3.7, <jats:italic>P<\/jats:italic>\u2009=\u20090.049).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Approximately half of patients with at least severe TR presented with two or more extra-cardiac systemic manifestations, which may incur a 1.9-fold higher risk of all-cause death or cardiac rehospitalization than TR patients with one or less extra-cardiac involvement.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12872-024-03805-2","type":"journal-article","created":{"date-parts":[[2024,3,12]],"date-time":"2024-03-12T20:04:04Z","timestamp":1710273844000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Risk stratification by systemic manifestations secondary to hemodynamic disorders of patients with severe tricuspid regurgitation"],"prefix":"10.1186","volume":"24","author":[{"given":"Xing-Yu","family":"Ji","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fei","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fang-Lin","family":"Lu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuan","family":"Feng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mao","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tian-Yuan","family":"Xiong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,3,12]]},"reference":[{"key":"3805_CR1","doi-asserted-by":"publisher","first-page":"3515","DOI":"10.1093\/eurheartj\/ehw229","volume":"37","author":"JL d\u2019Arcy","year":"2016","unstructured":"d\u2019Arcy JL, Coffey S, Loudon MA, Kennedy A, Pearson-Stuttard J, Birks J, Frangou E, Farmer AJ, Mant D, Wilson J, Myerson SG, Prendergast BD. Large-scale community echocardiographic screening reveals a major burden of undiagnosed valvular heart disease in older people: the OxVALVE Population Cohort Study. Eur Heart J. 2016;37:3515\u201322.","journal-title":"Eur Heart J"},{"key":"3805_CR2","doi-asserted-by":"publisher","first-page":"476","DOI":"10.1093\/eurheartj\/ehy641","volume":"40","author":"N Wang","year":"2019","unstructured":"Wang N, Fulcher J, Abeysuriya N, McGrady M, Wilcox I, Celermajer D, Lal S. Tricuspid regurgitation is associated with increased mortality independent of pulmonary pressures and right heart failure: a systematic review and meta-analysis. Eur Heart J. 2019;40:476\u201384.","journal-title":"Eur Heart J"},{"key":"3805_CR3","doi-asserted-by":"publisher","first-page":"565","DOI":"10.1161\/CIRCINTERVENTIONS.109.878983","volume":"2","author":"S Agarwal","year":"2009","unstructured":"Agarwal S, Tuzcu EM, Rodriguez ER, Tan CD, Rodriguez LL, Kapadia SR. Interventional Cardiology Perspective of functional tricuspid regurgitation. Circ Cardiovasc Interv. 2009;2:565\u201373.","journal-title":"Circ Cardiovasc Interv"},{"key":"3805_CR4","doi-asserted-by":"publisher","unstructured":"Alqahtani F, Berzingi CO, Aljohani S, Hijazi M, Al-Hallak A, Alkhouli M. Contemporary trends in the Use and outcomes of Surgical Treatment of Tricuspid Regurgitation. J Am Heart Assoc. 2017;6. https:\/\/doi.org\/10.1161\/JAHA.117.007597.","DOI":"10.1161\/JAHA.117.007597"},{"issue":"9","key":"3805_CR5","doi-asserted-by":"publisher","first-page":"1117","DOI":"10.1002\/ejhf.1547","volume":"21","author":"F Schlotter","year":"2019","unstructured":"Schlotter F, Orban M, Rommel KP, et al. Aetiology-based clinical scenarios predict outcomes of transcatheter e dge-to-edge tricuspid valve repair of functional tricuspid regurgitati on [J]. Eur J Heart Fail. 2019;21(9):1117\u201325.","journal-title":"Eur J Heart Fail"},{"key":"3805_CR6","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1097\/CM9.0000000000002440","volume":"136","author":"F Lu","year":"2023","unstructured":"Lu F, Xiong T, Chen M. Evaluation of systemic impact of tricuspid regurgitation: an appeal for the notion of tricuspid regurgitation syndrome. Chin Med J (Engl). 2023;136:138\u201340.","journal-title":"Chin Med J (Engl)"},{"issue":"4","key":"3805_CR7","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1016\/j.echo.2017.01.007","volume":"30","author":"WA Zoghbi","year":"2017","unstructured":"Zoghbi WA, Adams D, Bonow RO, et al. 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[J]. J Am Soc Echocardiogr. 2017;30(4):303\u201371.","journal-title":"J Am Soc Echocardiogr"},{"issue":"12","key":"3805_CR8","doi-asserted-by":"publisher","first-page":"1342","DOI":"10.1093\/ehjci\/jex139","volume":"18","author":"RT Hahn","year":"2017","unstructured":"Hahn RT, Zamorano JL. The need for a new tricuspid regurgitation grading scheme[J]. Eur Heart J - Cardiovasc Imaging. 2017;18(12):1342\u20133.","journal-title":"Eur Heart J - Cardiovasc Imaging"},{"issue":"36","key":"3805_CR9","doi-asserted-by":"publisher","first-page":"3599","DOI":"10.1093\/eurheartj\/ehab368","volume":"42","author":"TA Mcdonagh","year":"2022","unstructured":"Mcdonagh TA, Metra M, Adamo M, et al. 2021 ESC guidelines for the diagnosis and treatment of acute and chron ic heart failure[J]. Eur Heart J. 2022;42(36):3599\u2013726.","journal-title":"Eur Heart J"},{"key":"3805_CR10","doi-asserted-by":"publisher","first-page":"897","DOI":"10.1016\/S0002-9149(98)01064-9","volume":"83","author":"JP Singh","year":"1999","unstructured":"Singh JP, Evans JC, Levy D, Larson MG, Freed LA, Fuller DL, Lehman B, Benjamin EJ. Prevalence and clinical determinants of mitral, tricuspid, and aortic regurgitation (the Framingham Heart Study). Am J Cardiol. 1999;83:897\u2013902.","journal-title":"Am J Cardiol"},{"key":"3805_CR11","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, Oguz D, Michelena H, Maalouf J, Mahoney DW, Enriquez-Sarano M. Burden of Tricuspid Regurgitation in patients diagnosed in the community setting. JACC Cardiovasc Imaging. 2019;12:433\u201342.","journal-title":"JACC Cardiovasc Imaging"},{"key":"3805_CR12","doi-asserted-by":"crossref","unstructured":"Alushi B, Beckhoff F, Leistner DM, Staehli BE, Jamaluddin M, Bigalke B, Latib A, Falk V, Grubitzch H, Landmesser U, Hahn R, Lauten A. 5938Mortality risk stratification in patients with severe tricuspid regurgitation - Insights from the Tricuspid Regurgitation REgistry (TRuE). Eur Heart J. 2019;40:ehz746.0088.","DOI":"10.1093\/eurheartj\/ehz746.0088"},{"key":"3805_CR13","doi-asserted-by":"publisher","first-page":"1258","DOI":"10.1016\/j.jtcvs.2006.08.049","volume":"132","author":"O Stuge","year":"2006","unstructured":"Stuge O, Liddicoat J. Emerging opportunities for cardiac surgeons within structural heart disease. J Thorac Cardiovasc Surg. 2006;132:1258\u201361.","journal-title":"J Thorac Cardiovasc Surg"},{"key":"3805_CR14","doi-asserted-by":"publisher","first-page":"2902","DOI":"10.1253\/circj.CJ-11-0718","volume":"75","author":"C Izumi","year":"2011","unstructured":"Izumi C, Miyake M, Takahashi S, Matsutani H, Hashiwada S, Kuwano K, Hayashi H, Nakajima S, Nishiga M, Hanazawa K, Sakamoto J, Kondo H, Tamura T, Kaitani K, Yamanaka K, Nakagawa Y. Progression of isolated tricuspid regurgitation late after left-sided valve surgery - clinical features and mechanisms -: \u2013 clinical features and mechanisms \u2013. Circ J. 2011;75:2902\u20137.","journal-title":"Circ J"},{"key":"3805_CR15","doi-asserted-by":"publisher","first-page":"608","DOI":"10.1016\/j.jtcvs.2010.10.042","volume":"142","author":"O Yilmaz","year":"2011","unstructured":"Yilmaz O, Suri RM, Dearani JA, Sundt TM, Daly RC, Burkhart HM, Li Z, Enriquez-Sarano M, Schaff HV. Functional tricuspid regurgitation at the time of mitral valve repair for degenerative leaflet prolapse: the case for a selective approach. J Thorac Cardiovasc Surg. 2011;142:608\u201313.","journal-title":"J Thorac Cardiovasc Surg"},{"key":"3805_CR16","first-page":"e72","volume":"143","author":"CM Otto","year":"2021","unstructured":"Otto CM, Nishimura RA, Bonow RO, Carabello BA, Erwin JP, Gentile F, Jneid H, Krieger EV, Mack M, McLeod C, O\u2019Gara PT, Rigolin VH, Sundt TM, Thompson A, Toly C. 2020 ACC\/AHA Guideline for the management of patients with Valvular Heart Disease: a report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice guidelines. Circulation. 2021;143:e72\u2013e227.","journal-title":"Circulation"},{"key":"3805_CR17","doi-asserted-by":"publisher","first-page":"674","DOI":"10.1016\/j.jtcvs.2003.11.019","volume":"127","author":"PM McCarthy","year":"2004","unstructured":"McCarthy PM, Bhudia SK, Rajeswaran J, Hoercher KJ, Lytle BW, Cosgrove DM, Blackstone EH. Tricuspid valve repair: durability and risk factors for failure. J Thorac Cardiovasc Surg. 2004;127:674\u201385.","journal-title":"J Thorac Cardiovasc Surg"},{"key":"3805_CR18","doi-asserted-by":"publisher","first-page":"2953","DOI":"10.1016\/j.jacc.2017.10.039","volume":"70","author":"CJ Zack","year":"2017","unstructured":"Zack CJ, Fender EA, Chandrashekar P, Reddy YNV, Bennett CE, Stulak JM, Miller VM, Nishimura RA. National trends and outcomes in isolated tricuspid valve surgery. J Am Coll Cardiol. 2017;70:2953\u201360.","journal-title":"J Am Coll Cardiol"},{"key":"3805_CR19","doi-asserted-by":"crossref","unstructured":"Wang TKM, Akyuz K, Xu B, Gillinov M, Pettersson G, Griffin BP, Desai MY. Earlier surgery improves long-term survival compared to class I surgical indications and infective endocarditis surgery for isolated severe tricuspid regurgitation. Eur Heart J. 2020;41:ehaa946.2687.","DOI":"10.1093\/ehjci\/ehaa946.2687"},{"key":"3805_CR20","doi-asserted-by":"publisher","unstructured":"Kim M, Lee H, Park J, Kim J, Lee S, Kim Y, Chang S, Kim H. Preoperative right ventricular free-wall longitudinal strain as a prognosticator in isolated surgery for severe functional tricuspid regurgitation. J Am Heart Assoc. 2021;10. https:\/\/doi.org\/10.1161\/JAHA.120.019856.","DOI":"10.1161\/JAHA.120.019856"},{"key":"3805_CR21","doi-asserted-by":"publisher","first-page":"2260","DOI":"10.1016\/j.jcin.2021.07.048","volume":"14","author":"A Sugiura","year":"2021","unstructured":"Sugiura A, Tanaka T, Kavsur R, \u00d6zt\u00fcrk C, Vogelhuber J, Wilde N, Becher MU, Zimmer S, Nickenig G, Weber M. Leaflet configuration and residual tricuspid regurgitation after transcatheter edge-to-edge tricuspid repair. JACC Cardiovasc Interv. 2021;14:2260\u201370.","journal-title":"JACC Cardiovasc Interv"},{"key":"3805_CR22","doi-asserted-by":"publisher","first-page":"579","DOI":"10.5603\/CJ.a2021.0046","volume":"28","author":"S Otto","year":"2021","unstructured":"Otto S, Velichkov M, Hamadanchi A, Schulze PC, Moebius-Winkler S. The impact of tricuspid annular geometry on outcome after percutaneous edge-to-edge repair for severe tricuspid regurgitation. Cardiol J. 2021;28:579\u201388.","journal-title":"Cardiol J"},{"key":"3805_CR23","doi-asserted-by":"crossref","unstructured":"Dreyfus J, Audureau E, Bohbot Y, Coisne A, Lavie-Badie Y, Bouchery M, Flagiello M, Bazire B, Eggenspieler F, Viau F, Riant E, Mbaki Y, Eyharts D, Senage T, Modine T, Nicol M, Doguet F, Nguyen V, Le Tourneau T, Tribouilloy C, Donal E, Tomasi J, Habib G, Selton-Suty C, Raffoul R, Iung B, Obadia J-F, Messika-Zeitoun D. TRI-SCORE: a new risk score for in-hospital mortality prediction after isolated tricuspid valve surgery. Eur Heart J. 2021. ehab679.","DOI":"10.1093\/eurheartj\/ehab679"},{"key":"3805_CR24","doi-asserted-by":"publisher","first-page":"1932","DOI":"10.1093\/eurheartj\/ehz614","volume":"41","author":"CC Chang","year":"2020","unstructured":"Chang CC, Veen KM, Hahn RT, Bogers AJJC, Latib A, Oei FBS, Abdelghani M, Modolo R, Ho SY, Abdel-Wahab M, Fattouch K, Bosmans J, Caliskan K, Taramasso M, Serruys PW, Bax JJ, van Mieghem NMDA, Takkenberg JJM, Lurz P, Modine T, Soliman O. Uncertainties and challenges in surgical and transcatheter tricuspid valve therapy: a state-of-the-art expert review. Eur Heart J. 2020;41:1932\u201340.","journal-title":"Eur Heart J"}],"container-title":["BMC Cardiovascular Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12872-024-03805-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12872-024-03805-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12872-024-03805-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,12]],"date-time":"2024-03-12T20:06:47Z","timestamp":1710274007000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmccardiovascdisord.biomedcentral.com\/articles\/10.1186\/s12872-024-03805-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,12]]},"references-count":24,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["3805"],"URL":"https:\/\/doi.org\/10.1186\/s12872-024-03805-2","relation":{},"ISSN":["1471-2261"],"issn-type":[{"value":"1471-2261","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,12]]},"assertion":[{"value":"17 November 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 February 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 March 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was approved by institutional review board of West China Hospital, Sichuan University with a waiver to obtain patient informed consent due to retrospective study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"149"}}