Impact of Atrial Fibrillation on Tricuspid and Mitral Annular Dilatation and Valvular Regurgitation.

Novel Mechanistic Insights Into Atrial Functional Mitral Regurgitation – 3-Dimensional Echocardiographic Study –

“…3,5-8, 20 Our findings provide novel evidence regarding this issue. Patients with AF had a trend of MA enlargement compared with the control subjects; however, that did not always lead to significant MR, which may be partly explained by compensatory enlargement of the leaflets, so-called mitral adaptation.…”

“…Long-standing AF can cause significant dilatation of not only the LA but also the RA, leading to mitral and tricuspid annular dilatation and causing valvular regurgitation. 20 Dilatation and overload of the right-sided heart may interfere with the MA structure and dynamics; however, further research is required to confirm that. In the present study, E velocity, E' velocity and E/E' ratio tended to be higher in parallel with deterioration of MR.…”

Tricuspid Regurgitation after Mitral Valve Repair for Degenerative Mitral Regurgitation

“…12) Zhou and coworkers demonstrated a greater impact of Af on annular dilatation and its consequent regurgitation in tricuspid valve than in mitral valve in details. 13) Despite the absence of statistical difference, our results of consistently higher percentage of Af in the TR up-grade group and lower one in the down-grade group may be similar to those of above-mentioned investigations. Although the highest (100%) rate of Maze operation performed for Af in the TR down-grade group can support its signifi cance to prevent TR progression, its second higher, not lowest, rate in the up-grade group may suggest the presence of some other contributing factors in postoperative TR progression besides Af.…”

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

“…Wady zastawkowe mogą się wiązać ze zwiększonym ryzykiem zakrzepowo-zatorowym, które prawdopodobnie sumuje się z ryzykiem udaru mózgu u pacjentów z AF [263]. Podobnie jak w przypadku niewydolności serca, wady zastawkowe i AF wchodzą we wzajemne interakcje i podtrzymują się wzajemnie poprzez przeciążenie objętościowe i ciśnieniowe, kardiomiopatię tachyarytmiczną, a także za pośrednictwem czynników neurohumoralnych [264][265][266][267][268][269][270]. Jeżeli dysfunkcja zastawki jest ciężka, to AF moż-na uważać za wskaźnik postępującej choroby, a więc jego obecność przemawia za naprawą lub wymianą zastawki [271].…”