Predictors for the Development of Severe Tricuspid Regurgitation with Anatomically Normal Valve in Patients with Atrial Fibrillation

Najib, Mohammad Q.; Vinales, Karyne L.; Vittala, Satya S.; Challa, Suresh; Lee, Howard R.; Chaliki, Hari P.

doi:10.1111/j.1540-8175.2011.01565.x

Cited by 95 publications

(75 citation statements)

References 16 publications

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“…Yamasaki et al 6 evaluated 11 patients with severe idiopathic TR whose clinical features included chronic AF, RA enlargement, annular dilatation, and diminished fibrillation waves on ECG. Najib et al 7 analyzed 42 patients with severe FTR and AF and found that, in the absence of pulmonary hypertension, FTR occurred in older patients with chronic AF secondary to RA enlargement, altered RV function, and TV annular dilatation, which is consistent with the present study. Similar to the results of Yamasaki et al 6 and Najib et al, 7 we also found .…”

Section: Characterization Of Af-tr In Previous Studiessupporting

confidence: 80%

“…Najib et al 7 analyzed 42 patients with severe FTR and AF and found that, in the absence of pulmonary hypertension, FTR occurred in older patients with chronic AF secondary to RA enlargement, altered RV function, and TV annular dilatation, which is consistent with the present study. Similar to the results of Yamasaki et al 6 and Najib et al, 7 we also found . Compared with normal controls, patients with AF-TR had a larger TV annular area and lower ratio of total leaflet length:closure length but comparable tethering of the leaflets.…”

Section: Characterization Of Af-tr In Previous Studiessupporting

confidence: 80%

“…To date, 3 small studies have reported an association between chronic AF and FTR with normal leaflet motion. 6,7,21 Girard et al 21 first reported 3 patients with severe idiopathic TR and chronic AF, all of whom had a dilated annulus but otherwise normal TV leaflets on surgical inspection. Yamasaki et al 6 evaluated 11 patients with severe idiopathic TR whose clinical features included chronic AF, RA enlargement, annular dilatation, and diminished fibrillation waves on ECG.…”

Section: Characterization Of Af-tr In Previous Studiesmentioning

confidence: 99%

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Functional Tricuspid Regurgitation Caused by Chronic Atrial Fibrillation

Utsunomiya

Itabashi

Mihara

et al. 2017

Circ: Cardiovascular Imaging

195

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Background— Functional tricuspid regurgitation (TR) with a structurally normal tricuspid valve (TV) may occur secondary to chronic atrial fibrillation (AF). However, the clinical and echocardiographic differences according to functional TR subtypes are unclear. Therefore, characterization of functional TR because of chronic AF (AF-TR) remains undetermined. Methods and Results— To investigate the prevalence of AF-TR, 437 patients with moderate to severe TR underwent 3-dimensional (3D) transesophageal echocardiography. TR severity was determined by the averaged vena contracta width on apical and parasternal inflow views. The prevalence of AF-TR was 9.2%, whereas that of functional TR because of left-sided heart disease was 45.3%. Clinical features of AF-TR included advanced age, female sex, greater right atrial than left atrial enlargement and lower systolic pulmonary artery pressure compared with left-sided heart disease-TR with sinus rhythm (all P <0.05). In 3D TV assessment, patients with AF-TR had a larger TV annular area with weaker annular contraction (both P <0.001) but a smaller tethering angle ( P <0.001) despite a similar leaflet coaptation status compared with patients with left-sided heart disease-TR with sinus rhythm. On multivariable analysis, only the TV annular area in midsystole (coefficient, 0.059; 95% confidence interval, 0.041–0.078 per 100 mm 2 ; P <0.001) was associated with TR severity in AF-TR. The annular area was more closely correlated with the right atrial volume than right ventricular end-systolic volume in AF-TR ( P <0.001). Conclusions— AF-TR is not rare and is associated with advanced age and right atrial enlargement. TV deformations and their association with right heart remodeling differ between AF-TR and left-sided heart disease-TR. Our results suggest that in patients with TR secondary to AF, TV annuloplasty should be effective because this entity has annular dilatation without leaflet deformation.

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Section: Characterization Of Af-tr In Previous Studiessupporting

confidence: 80%

Section: Characterization Of Af-tr In Previous Studiessupporting

confidence: 80%

Section: Characterization Of Af-tr In Previous Studiesmentioning

confidence: 99%

See 1 more Smart Citation

Functional Tricuspid Regurgitation Caused by Chronic Atrial Fibrillation

Utsunomiya

Itabashi

Mihara

et al. 2017

Circ: Cardiovascular Imaging

195

View full text Add to dashboard Cite

show abstract

“…Furthermore, these patients with idiopathic TR were older and atrial fibrillation was more common confirming prior smaller studies. 2,4,5 Approximately two-thirds of patients with severe TR in our study were female with no significant difference in this gender distribution among the 3 classifications of TR. Gender might play a role in determining susceptibility to developing severe TR.…”

Section: Discussionmentioning

confidence: 89%

Prevalence and Spectrum of Conditions Associated with Severe Tricuspid Regurgitation

Ong

Jue

2013

Echocardiography

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“…Severe TR may lead to elevated right atrial pressures and/or right atrial dilation, which may contribute to the occurrence of supraventricular arrhythmias 25 26. Indeed, earlier studies have revealed a high prevalence of supraventricular arrhythmias in patients with rTOF,26 27 which may precede death and sustained ventricular tachycardias 16.…”

Section: Discussionmentioning

confidence: 99%