The Emerging Role of Cardiac Magnetic Resonance and Cardiac Computed Tomography in the Evaluation of Patients With Tricuspid Regurgitation Eligible for Percutaneous Valve Interventions

Tricuspid regurgitation (TR) has shifted from being considered a benign condition to a clinically relevant entity with a potentially poor prognosis, leading to increasing diagnostic and therapeutic interest, particularly following the development of new transcatheter intervention techniques. Imaging is fundamental in the evaluation of valvular heart disease, and in the case of TR, cardiac magnetic resonance (CMR) and cardiac computed tomography (CCT) have emerged as essential and complementary tools to echocardiography. Although specific thresholds for intervention have not yet been clearly defined, integrating functional and anatomical parameters through CMR and CCT may help determine the optimal timing for treating patients with severe TR, thereby avoiding progression to irreversible right ventricular remodeling and the onset of heart failure, which significantly impacts prognosis. CMR enables accurate assessment of right ventricular volumes and function, as well as quantification of regurgitation severity. Moreover, advanced CMR techniques such as 4D-flow and myocardial strain analysis using feature tracking provide additional prognostic information. On the other hand, CCT, thanks to its high spatial and temporal resolution, allows detailed visualization of the tricuspid valve anatomy, playing a crucial role in patient selection and procedural planning for percutaneous interventions, as well as in follow-up evaluation.