Introduction
Functional tricuspid regurgitation(FTR) is the result of geometric changes in valve structure in the absence of valve structural lesions[1]. By far, FTR is most commonly associated with pulmonary hypertension(PH) or left heart disease, primarily due to right ventricular remodeling, resulting in lobular tethering and tricuspid valve annulus(TA) dilation[2, 3]. There is increasing evidence that FTR is not only a marker of concurrent cardiac disease, but also a potential driver of adverse cardiovascular events[3]. With the in-depth study on long-term follow-up management and prognosis of patients undergoing mitral valve replacement(MVR), the old idea that FTR can be improved after MVR has disappeared, and postoperative FTR can further aggravate or cause right ventricular dysfunction(RVD)[4]. Therefore, close follow-up of patients undergoing MVR is proposed to seek surgical intervention in FTR before severe RVD occurs[5, 6]. However, this follow-up process usually takes years to decades, giving clinicians ample time to intervene with FTR to prevent or delay disease progression and thereby improve patients’ long-term prognosis. Given the current challenges in the management of FTR after MVR, it is important to correctly understand the association between FTR and RVD. Always, several studies have verified a single FTR or cumulative FTR levels associated with postoperative RVD, but doesn’t take into account the FTR this progressive disease throughout the postoperative changes of the potential impact and over time, FTR level and FTR trajectory may occur large individual differences, FTR of long-term dynamic model can more accurately reflect the link[3]. As normal FTR levels may go unnoticed in clinical practice and there are few studies on the relationship between FTR longitudinal trajectory and RVD after MVR at home and abroad. Consequently, in this research, the Group Based Trajectory Modeling (GBTM) model was used to identify and evaluate the trend characteristics of FTR change trajectory after MVR, so as to explore its impact on late RV function.