Tricuspid regurgitation and outcomes in arrhythmogenic right ventricular cardiomyopathy: role of tricuspid annulus dilatation

“In this issue of the European Heart Journal, Donati and colleagues report a large multicentre cohort of patients with definite ARVC, providing a comprehensive evaluation of the prevalence, mechanisms, and prognostic implications of TR in this disease. Unlike previous cited reports, which primarily positioned TR as a marker of advanced HF, this study places right-sided valvular remodelling at the centre of the discussion. Among the different components of RV disease, tricuspid annular dilatation emerged as the anatomical feature most closely associated with significant TR.”

“Ultimately, the contribution of Donati et al. extends beyond reminding us that the tricuspid valve matters in ARVC. Rather, it shifts attention from the severity of regurgitation itself to the structural remodelling that underlies it. From this perspective, the tricuspid annulus emerges not merely as an anatomical structure, but as a readily accessible window into RV disease progression.”