Echocardiographic Parameters in the Assessment of Tricuspid Regurgitation Prognosis: What Is New?

Tricuspid regurgitation (TR) is associated with adverse clinical outcomes, highlighting the need for echocardiographic assessment beyond conventional severity grading. This narrative review examines the prognostic value and clinical applicability of established and emerging echocardiographic parameters. TR phenotype influences prognosis and response to transcatheter intervention, with more favourable outcomes in atrial than ventricular functional TR. The five-grade TR classification improves risk stratification, with massive or torrential TR associated with worse outcomes despite comparable procedural success. Right ventricular–pulmonary arterial coupling provides valuable prognostic information and may help identify an optimal therapeutic window for transcatheter intervention, particularly in patients with intermediate coupling values. The GLIDE score helps predict anatomical suitability and procedural success for transcatheter edge-to-edge repair, whereas high TRI-SCORE values (≥6) identify patients in whom a significant survival benefit from repair has not been demonstrated. Treatment decisions should therefore integrate symptoms, overall clinical status, procedural feasibility, and expected benefit through individualized Heart Team assessment. Following intervention, the severity of residual TR, ideally mild or less, remains a key determinant of procedural success.