Evidence map›Paper›PMID 40338038›Full record

Observational studyEuropean journal of heart failure2025

Aetiological phenotypes of atrial and ventricular secondary tricuspid regurgitation and their prognostic implications: insights from the CARE-TR registry.

Laura Lupi, Elena Antonioli, Angelica Praderio, Alessandro Villaschi, Elisa Soranzo, Nicola Saccani, Kamil Stankowski, Daniele Cocianni, Beniamino Pagliaro, Valeria Magni and 8 more

Abstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in European journal of heart failure, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Aetiology, prevalence, and prognosis.European heart journal supplements : journal of the European Society of Cardiology · 2026
    Article
  2. Article
  3. Review
  4. Review
  5. Article
  6. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Laura Lupi *Institute of Cardiology, ASST Spedali Civili di Brescia, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
Elena Antonioli *Division of Cardiology, ASST del Garda, Presidio Ospedaliero di Manerbio, Manerbio, Italy.
Angelica PraderioInstitute of Cardiology, ASST Spedali Civili di Brescia, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
Alessandro VillaschiDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy.
Elisa SoranzoCardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI) and University Hospital of Trieste, Trieste, Italy.
Nicola SaccaniInstitute of Cardiology, ASST Spedali Civili di Brescia, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
Kamil StankowskiDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy.
Daniele CocianniCardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI) and University Hospital of Trieste, Trieste, Italy.
Beniamino PagliaroDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy.
Valeria MagniDivision of Cardiology, ASST del Garda, Presidio Ospedaliero di Desenzano del Garda, Desenzano del Garda, Italy.
Marco LoffiDivision of Cardiology, Azienda Socio-Sanitaria Territoriale di Cremona, Cremona, Italy.
Daniela TomasoniInstitute of Cardiology, ASST Spedali Civili di Brescia, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
Matteo PagnesiInstitute of Cardiology, ASST Spedali Civili di Brescia, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
Antonio MangieriDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy.
Davide StolfoCardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI) and University Hospital of Trieste, Trieste, Italy.
Gianfranco SinagraCardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI) and University Hospital of Trieste, Trieste, Italy.
Marianna Adamo *Institute of Cardiology, ASST Spedali Civili di Brescia, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
Marco Metra *Institute of Cardiology, ASST Spedali Civili di Brescia, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsTo report prevalence and clinical outcomes of different aetiological phenotypes of atrial and ventricular secondary tricuspid regurgitation (ASTR/VSTR). METHODS AND

resultsThe Consecutive pAtients with seveRE Tricuspid Regurgitation evaluated in Heart Failure (HF) and Valve Clinics (CARE-TR) registry collected data from patients with at least severe tricuspid regurgitation (TR) enrolled at three Italian centres. The present analysis includes 648 patients with secondary TR, 22.1% with ASTR and 77.9% with VSTR. Patients with ASTR were further stratified in those with atrial fibrillation (AF, 25.2%), HF with preserved ejection fraction (HFpEF, 37.8%), and both (37.0%). Patients with VSTR were subdivided into those with severe left-sided valvular heart disease (LS-VHD, 28.5%), HF with reduced or mildly reduced ejection fraction (HFrEF/HFmrEF, 29.1%), HFpEF (35.5%), pre-capillary pulmonary hypertension (PH, 4.0%) and isolated right ventricular dysfunction (RVD, 2.9%). After a median follow-up of 498 days, 118 (18.2%) patients died and 153 (23.6%) were hospitalized for HF. Two-year survival free from the composite outcome of death or HF hospitalization was higher in patients with ASTR compared with those with VSTR (73.5% vs. 54.4%; p < 0.001). After adjustment for variables related with HF severity, VSTR remained independently associated with an increased risk of events (adjusted hazard ratio 2.00; 95% confidence interval 1.33-3.02; p = 0.001). Among ASTR patients, combined AF and HFpEF was associated with a poorer outcome compared with AF or HFpEF alone (60.2% vs. 80.5% vs. 83.6%; p = 0.022). Among patients with VSTR, overall survival free from the composite outcome was 85%, 65%, 54%, 39% and 38% for RVD, HFpEF, HFrEF/HFmrEF, severe LS-VHD, and pre-capillary PH, respectively (p < 0.001).

conclusionsIn a real-world population with at least severe secondary TR, 22% had ASTR and showed better outcomes as compared to VSTR. Among patients with ASTR, combination of AF and HFpEF was common and associated with the worst prognosis. Among patients with VSTR, those with pre-capillary PH had the poorest outcomes, followed by those with LS-VHD.

Indexed as

Heart FailureHeart VentriclesRegistriesTricuspid Valve InsufficiencyAgedAtrial FibrillationEchocardiographyFemaleFollow-Up StudiesHeart AtriaHumansItalyMaleMiddle AgedPhenotypePrevalenceAetiological phenotypesAtrial secondary tricuspid regurgitationOutcomesPrevalenceVentricular secondary tricuspid regurgitation

Identifiers

PMID40338038
PMCPMC12482845

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.