Tricuspid regurgitation management : a systematic review of clinical practice guidelines and recommendations
(2022) In European heart journal. Quality of care & clinical outcomes 8(3). p.238-248- Abstract
Tricuspid regurgitation (TR) is a highly prevalent condition and an independent risk factor for adverse outcomes. Multiple clinical guidelines exist for the diagnosis and management of TR, but the recommendations may sometimes vary. We systematically reviewed high-quality guidelines with a specific focus on areas of agreement, disagreement, and gaps in evidence. We searched MEDLINE and EMBASE (1 January 2011 to 30 August 2021), the Guidelines International Network International, Guideline Library, National Guideline Clearinghouse, National Library for Health Guidelines Finder, Canadian Medical Association Clinical Practice Guidelines Infobase, Google Scholar, and websites of relevant organizations for contemporary guidelines that were... (More)
Tricuspid regurgitation (TR) is a highly prevalent condition and an independent risk factor for adverse outcomes. Multiple clinical guidelines exist for the diagnosis and management of TR, but the recommendations may sometimes vary. We systematically reviewed high-quality guidelines with a specific focus on areas of agreement, disagreement, and gaps in evidence. We searched MEDLINE and EMBASE (1 January 2011 to 30 August 2021), the Guidelines International Network International, Guideline Library, National Guideline Clearinghouse, National Library for Health Guidelines Finder, Canadian Medical Association Clinical Practice Guidelines Infobase, Google Scholar, and websites of relevant organizations for contemporary guidelines that were rigorously developed (as assessed by the Appraisal of Guidelines for Research and Evaluation II tool). Three guidelines were finally retained. There was consensus on a TR grading system, recognition of isolated functional TR associated with atrial fibrillation, and indications for valve surgery in symptomatic vs. asymptomatic patients, primary vs. secondary TR, and isolated TR forms. Discrepancies exist in the role of biomarkers, complementary multimodality imaging, exercise echocardiography, and cardiopulmonary exercise testing for risk stratification and clinical decision-making of progressive TR and asymptomatic severe TR, management of atrial functional TR, and choice of transcatheter tricuspid valve intervention (TTVI). Risk-based thresholds for quantitative TR grading, robust risk score models for TR surgery, surveillance intervals, population-based screening programmes, TTVI indications, and consensus on endpoint definitions are lacking.
(Less)
- author
- organization
- publishing date
- 2022-05-05
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Tricuspid regurgitation • Guidelines • Systematic review • Valvular heart disease • Tricuspid valve • Transcatheter intervention
- in
- European heart journal. Quality of care & clinical outcomes
- volume
- 8
- issue
- 3
- pages
- 11 pages
- publisher
- Oxford University Press
- external identifiers
-
- scopus:85129997850
- pmid:34878111
- ISSN
- 2058-1742
- DOI
- 10.1093/ehjqcco/qcab081
- language
- English
- LU publication?
- yes
- additional info
- Publisher Copyright: © The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology.
- id
- 606266e0-2cb9-4770-a333-edea53fef0f8
- date added to LUP
- 2022-08-22 10:17:43
- date last changed
- 2024-06-13 18:21:47
@article{606266e0-2cb9-4770-a333-edea53fef0f8,
abstract = {{<p>Tricuspid regurgitation (TR) is a highly prevalent condition and an independent risk factor for adverse outcomes. Multiple clinical guidelines exist for the diagnosis and management of TR, but the recommendations may sometimes vary. We systematically reviewed high-quality guidelines with a specific focus on areas of agreement, disagreement, and gaps in evidence. We searched MEDLINE and EMBASE (1 January 2011 to 30 August 2021), the Guidelines International Network International, Guideline Library, National Guideline Clearinghouse, National Library for Health Guidelines Finder, Canadian Medical Association Clinical Practice Guidelines Infobase, Google Scholar, and websites of relevant organizations for contemporary guidelines that were rigorously developed (as assessed by the Appraisal of Guidelines for Research and Evaluation II tool). Three guidelines were finally retained. There was consensus on a TR grading system, recognition of isolated functional TR associated with atrial fibrillation, and indications for valve surgery in symptomatic vs. asymptomatic patients, primary vs. secondary TR, and isolated TR forms. Discrepancies exist in the role of biomarkers, complementary multimodality imaging, exercise echocardiography, and cardiopulmonary exercise testing for risk stratification and clinical decision-making of progressive TR and asymptomatic severe TR, management of atrial functional TR, and choice of transcatheter tricuspid valve intervention (TTVI). Risk-based thresholds for quantitative TR grading, robust risk score models for TR surgery, surveillance intervals, population-based screening programmes, TTVI indications, and consensus on endpoint definitions are lacking.</p>}},
author = {{Ricci, Fabrizio and Bufano, Gabriella and Galusko, Victor and Sekar, Baskar and Benedetto, Umberto and Awad, Wael I. and Di Mauro, Michele and Gallina, Sabina and Ionescu, Adrian and Badano, Luigi and Khanji, Mohammed Y.}},
issn = {{2058-1742}},
keywords = {{Tricuspid regurgitation • Guidelines • Systematic review • Valvular heart disease • Tricuspid valve • Transcatheter intervention}},
language = {{eng}},
month = {{05}},
number = {{3}},
pages = {{238--248}},
publisher = {{Oxford University Press}},
series = {{European heart journal. Quality of care & clinical outcomes}},
title = {{Tricuspid regurgitation management : a systematic review of clinical practice guidelines and recommendations}},
url = {{http://dx.doi.org/10.1093/ehjqcco/qcab081}},
doi = {{10.1093/ehjqcco/qcab081}},
volume = {{8}},
year = {{2022}},
}