Abstract

Tricuspid regurgitation (TR) ranges from asymptomatic to severe right-sided heart failure. TR is classified as primary (10–25%), resulting from structural valve damage due to rheumatic heart disease, infective endocarditis, or congenital defects, and secondary (75–90%), arising from right ventricular dysfunction associated with pulmonary hypertension, left-sided heart failure, or atrial fibrillation. In Asian populations, higher prevalence of rheumatic heart disease, atrial fibrillation, hypertension, diabetes, and limited healthcare access exacerbate outcomes. Pathophysiology varies by etiology: primary TR reflects intrinsic valve pathology, while secondary TR involves annular dilation and ventricular remodeling. Clinical manifestations range from no symptoms to fatigue, dyspnea, and peripheral edema. Echocardiography remains the diagnostic gold standard, with cardiac MRI or CT reserved for complex cases. Management depends on severity, with medical therapy for mild-to-moderate cases and surgical or transcatheter repair for severe TR. Transcatheter tricuspid valve repair shows promise in high-risk patients. Early detection and intervention improve prognosis, yet healthcare disparities limit outcomes, highlighting the need to optimize minimally invasive strategies and access to care globally.

Key words: Tricuspid regurgitation, right-sided heart failure, transcatheter tricuspid valve repair, hypertension, Asian population.