The present survey, led by the EACVI Scientific Initiative Committee, aims to identify the most common imaging modalities, techniques and imaging parameters used in the diagnostic workup and management of patients with tricuspid regurgitation (TR) in routine clinical practice. Additionally, this survey investigates the current utilisation and accessibility of advanced imaging modalities such as strain and 3D echocardiography, cardiac computed tomography (CT), and cardiac magnetic resonance imaging (CMR) in the evaluation of patients with TR.

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· The survey is anonymous
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* 1. May we please ask you to confirm you have read the clauses above and accept participation in this survey? (single choice)

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* 2. What is your type of practice/hospital ? (single choice)

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* 3. In which country do you work? (single choice)

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* 4. What is your academic level? (single choice)

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* 5. What is your medical speciality or subspeciality? (single choice)

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* 6. Which echocardiographic modalities do you employ to assess severe tricuspid regurgitation (TR) patients? (select all that apply)

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* 7. Regarding the echocardiographic modality(ies) selected above, how often do you perform:

  Routinely Sometimes, in selected patients Rarely Never
2D transthoracic echocardiography
2D transesophageal echocardiography (TOE)
3D transthoracic echocardiography
3D TOE

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* 8. How often do you use the novel classification of secondary TR in atrial and ventricular subtypes, when describing the TR mechanism in your clinical report? (single choice)

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* 9. How often do you use the novel classification of tricuspid valve anatomy based on the number of tricuspid valve (TV) leaflets in your clinical report (i.e. type I = trileaflet, type II = bileaflet, type III = four leaflets, type IV = five or more leaflets – Hahn R et al. Proposal for a Standard Echocardiographic Tricuspid Valve Nomenclature, JACC Cardiovasc Imaging 2021;14:1299-1305 (single choice)

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* 10. Which parameters do you routinely report to describe the right ventricular (RV) systolic function in patients with severe TR? (multiple choice )

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* 11. How often do you assess RV-pulmonary artery (PA) coupling in patients with severe TR? (multiple choice)

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* 12. *skip this question if you do not assess RV-PA coupling in patients with severe TR
Which parameter(s) do you use to assess RV-PA coupling in patients with severe TR ? (multiple choice)

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* 13. *skip this question if you use RV longitudinal strain routinely in patients with severe TR
What is the main reason why you do not measure routinely RV longitudinal strain in patients with severe TR? (single choice )

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* 14. *skip this question if you use RVEF routinely in patients with severe TR
What is the main reason why you do not measure routinely RVEF by 3D echocardiography in patients with severe TR? (single choice )

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* 15. How do you routinely assess RV size in patients with severe TR? (multiple choice)

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* 16. How do you routinely assess the RA size in patients with severe TR? (multiple choice)

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* 17. What echocardiographic parameters do you routinely use for grading TR? (multiple choice)

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* 18. When TR severity is unclear based on conventional parameters (2D vena contracta, EROA, regurgitant volume), what is your next approach to assessing TR severity? (multiple choice)

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* 19. Do you use the newly proposed 5-grade scheme (i.e. mild, moderate, severe, massive and torrential TR) to describe TR severity in your reports? (single choice)

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* 20. How do you routinely measure the tricuspid annulus (TA) size in TR patients? (multiple choice)

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* 21. *skip this question if you measure routinely TV annulus by 3D echocardiography in patients with severe TR
What is the main reason why you do not measure routinely TV annulus by 3D echocardiography in patients with severe TR? (single choice )

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* 22. Do you utilise cardiac CT in patients with severe TR? (multiple choice)

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* 23. Do you utilise CMR in patients with severe TR? (multiple choice)

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* 24. Do you utilise right heart catheterisation in patients with severe TR? (single choice)

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* 25. In patients with severe TR and cardiac implantable electronic devices (CIED), which technique do you generally use to assess the position of the CIED lead and the relationship with TV leaflet motion? (multiple choice)

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* 26. In patients with severe TR, how do you evaluate the systemic venous congestion? (multiple choice)

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