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Tricuspid regurgitation (TR) is the second most common VHD after MR. Its prevalence also increases with age, with an estimated incidence of up to 6% in elderly population. When adjusted to age (among other confounders), survival is worse for patients with moderate and severe TR. We aim to explore the prevalence, mechanisms, and clinical implications of tricuspid valve regurgitation in elderly subjects screened at a tertiary center in Cairo, Egypt.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Consecutive patients ≥60-year-old presenting to the echocardiography clinic |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Echocardiography | Diagnostic Test | A comprehensive 2- and 3-dimensional transthoracic echocardiography (TTE) assessment of the tricuspid valve and right side of the heart at baseline. |
| Measure | Description | Time Frame |
|---|---|---|
| Prevalence of tricuspid valve regurgitation in the elderly | Prevalence of mild, moderate, and severe TR in enrolled patients | Baseline (at enrolment) |
| All-cause mortality | Incidence of death from any cause | At 6 months |
| Cardiovascular mortality | Incidence of cardiovascular death, defined as death attributable to myocardial ischemia and infarction, heart failure, cardiac arrest because of other or unknown cause, or cerebrovascular accident. | At 6 months |
| Rehospitalization for congestive heart failure | Incidence of new-onset or worsening signs and symptoms of heart failure that required urgent therapy and resulted in hospitalization. | At 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Classification of tricuspid valve regurgitation in the elderly | Classify the type of TR according to the main morphologic and/or functional abnormality. The classification will be done according to the following proposal, the TR could be 1- primary (organic) if there is an anatomical abnormality of the tricuspid valve apparatus. 2- secondary (functional) if the tricuspid valve apparatus was normal but the TR due to annular dilation. If the annular dilation is due to right ventricular volume or/and pressure overload, the TR will classify as ventricular TR, whereas if the annular dilation is due to atrial fibrillation, the TR will classify as atrial TR. The last type of TR is due to the implantation of a cardiac implantable electronic device (CIED) which will classify as CIED-related TR. |
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Inclusion Criteria:
Exclusion Criteria:
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Consecutive patients ≥ 60 years old presenting to the echocardiography clinic.
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| Name | Affiliation | Role |
|---|---|---|
| Mohammad Abdelghani, MD, PhD | Al-Azhar Cardiology Research Institute | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Al Hussein University Hospital of Al-Azhar University | Cairo | Egypt |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41955173 | Derived | Abdelghani M, Abdelshafy M, Muharram M, Elbadawi M, Mohey S, Elnahas AM, Elsoudi M, Magdy A, Mokhaimar B, Galal AM, Saed A, Attia W. Prevalence, Pathophysiologic Mechanisms, and Clinical Outcomes of Tricuspid Regurgitation in the Elderly: Results from the TREY Registry. Cardiology. 2026 Apr 9:1-11. doi: 10.1159/000551955. Online ahead of print. | |
| 41838068 |
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| ID | Term |
|---|---|
| D014262 | Tricuspid Valve Insufficiency |
| D006349 | Heart Valve Diseases |
| ID | Term |
|---|---|
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
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| ID | Term |
|---|---|
| D004452 | Echocardiography |
| ID | Term |
|---|---|
| D057791 | Cardiac Imaging Techniques |
| D003952 | Diagnostic Imaging |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
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| Baseline |
| Change in New York Heart Association (NYHA) functional class | New York Heart Association [NYHA] functional class (I-IV) will be assessed in all participants at baseline and at follow-up visits (or by phone interviews). NYHA Class I: No symptoms and no limitation in ordinary physical activity, e.g. shortness of breath when walking, climbing stairs etc. NYHA Class II: Mild symptoms (mild shortness of breath and/or angina) and slight limitation during ordinary activity. NYHA Class III: Marked limitation in activity due to symptoms, even during less-than-ordinary activity, e.g. walking short distances (20-100 m). Comfortable only at rest. NYHA Class IV: Severe limitations. Experiences symptoms even while at rest. Mostly bedbound patients. | At 6, 12 and 60 months |
| All-cause mortality | Incidence of death from any cause | At 12 and 60 months |
| Cardiovascular mortality | Incidence of cardiovascular death, defined as death attributable to myocardial ischemia and infarction, heart failure, cardiac arrest because of other or unknown cause, or cerebrovascular accident. | At 12 and 60 months |
| Rehospitalization for congestive heart failure | Incidence of new-onset or worsening signs and symptoms of heart failure that required urgent therapy and resulted in hospitalization. | At 12 and 60 months |
| Abdelghani M, Abdelshafy M, Elbadawi M, Mohey S, Elnahas AM, Soltan ME, Elsisi MH, Eltawela HA, Muharram M, Attia W. Tricuspid annulus dilatation in secondary tricuspid regurgitation: impact of the echocardiographic view and the cardiac-cycle phase of measurement. Heart Vessels. 2026 Mar 15. doi: 10.1007/s00380-026-02666-3. Online ahead of print. |
| 38818766 | Derived | Abdelghani M, Mohey S, Elnahas AM, Elshernouby KA, Muharram M, Gebaly M, Mokhaimar B, Elbadawi M, Diab RA, Abdelshafy M, Soliman O, Attia W. Tricuspid valve and right-heart chamber remodelling in elderly subjects with secondary tricuspid regurgitation. Acta Cardiol. 2024 Nov;79(9):1011-1020. doi: 10.1080/00015385.2024.2359657. Epub 2024 May 31. |
| D014463 | Ultrasonography |
| D006334 | Heart Function Tests |
| D003935 | Diagnostic Techniques, Cardiovascular |