Secondary Tricuspid Regurgitation: Pathophysiology, Incidence and Prognosis

Gerçek, Muhammed; Rudolph, Volker

doi:10.3389/fcvm.2021.701243

Cited by 18 publications

(21 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Recently, echocardiographic studies have reported that different mechanisms of FTR would lead to different geometric changes in TA ( 17 ). Compared with ventricular FTR, atrial FTR is more dilated and has a more posteriorly displaced annulus ( 18 ), while pulmonary hypertension-related FTR correlates more significantly with leaflet tethering during RV elongation compared with atrial FTR ( 19 ).…”

Section: Discussionmentioning

confidence: 99%

Tricuspid Annulus Dilation in Patients With Combined Functional Tricuspid Regurgitation and Left-Heart Valvular Disease: Does Septal Annulus Not Dilate?

Teng

Dai

Zou

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

BackgroundThis study aimed to investigate the course of tricuspid annulus dilation in functional tricuspid regurgitation with varied severities by direct intraoperative assessment.MethodsA total of 317 patients who underwent left heart surgery and concomitant tricuspid repair were divided into three groups according to the severity of the functional tricuspid regurgitation (mild, moderate and severe). Demographic and echocardiographic data were collected. The length of each tricuspid annulus segment was measured intraoperatively. The risk factors for preoperative severe functional tricuspid regurgitation and its postoperative recurrence were identified, and the impact of each tricuspid annulus segment on postoperative recurrence was compared.ResultsIn the course of tricuspid annulus dilation, the posterior annulus dilated 17% (group 1: 33.31 ± 6.94 mm vs. group 2: 35.56 ± 7.63 vs. group 3: 38.98 ± 8.70, p < 0.01), the anterior annulus dilated 13.4% (group 1: 36.71 ± 6.30 mm vs. group 2: 38.21 ± 8.35 vs. group 3: 41.63 ± 9.20, p < 0.01), and the septal annulus dilated 11.4% (group 1: 38.11 ± 5.28 mm vs. group 2: 39.76 ± 6.90 vs. group 3: 42.46 ± 7.50, p < 0.01). Tricuspid annulus circumference index (p < 0.01) independently correlated with preoperative severe tricuspid regurgitation and postoperative recurrence. When patients were grouped based on the length of each segment, the septal annulus demonstrated significantly higher sensitivity (p < 0.001) to postoperative recurrence than the anterior (p = 0.085) or posterior annulus (p = 0.262).ConclusionsThis study revealed that each segment of tricuspid annulus could dilate in functional tricuspid regurgitation and highlighted the potential benefits of septal annulus plication in tricuspid annuloplasty, which may aid in the development of a methodology for prosthetic ring annuloplasty.

show abstract

Section: Discussionmentioning

confidence: 99%

Tricuspid Annulus Dilation in Patients With Combined Functional Tricuspid Regurgitation and Left-Heart Valvular Disease: Does Septal Annulus Not Dilate?

Teng

Dai

Zou

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

show abstract

“…Advances in three-dimensional (3D) echocardiography imaging, including machine learning algorithms, provide a more reliable and feasible examination of the right ventricle without geometrical assumptions [1,11]. Furthermore, the pathophysiology of RV function is often related to tricuspid regurgitation (TR) [12,13]. A mild degree of TR is highly prevalent and is usually considered a benign incidental finding on routine echocardiography [12].…”

Section: Introductionmentioning

confidence: 99%

Echocardiography Imaging of the Right Ventricle: Focus on Three-Dimensional Echocardiography

2023

View full text Add to dashboard Cite

Right ventricular function strongly predicts cardiac death and adverse cardiac events in patients with cardiac diseases. However, the accurate right ventricular assessment by two-dimensional echocardiography is limited due to its complex anatomy, shape, and load dependence. Advances in cardiac imaging and three-dimensional echocardiography provided more reliable information on right ventricular volumes and function without geometrical assumptions. Furthermore, the pathophysiology of right ventricular dysfunction and tricuspid regurgitation is frequently connected. Three-dimensional echocardiography allows a more in-depth structural and functional evaluation of the tricuspid valve. Understanding the anatomy and pathophysiology of the right side of the heart may help in diagnosing and managing the disease by using reliable imaging tools. The present review describes the challenging echocardiographic assessment of the right ventricle and tricuspid valve apparatus in clinical practice with a focus on three-dimensional echocardiography.

show abstract

“…In addition, despite optimal medical management of primary cardiac pathology such as ischemic heart disease and/or cardiomyopathy, patients can still experience refractory congestive symptoms due to the progression of secondary valvular disease (tricuspid and/or mitral regurgitation). Tricuspid regurgitation (TR), especially secondary regurgitation, has been a trifled valvular pathology that has gained some attention in recent times as the milieu of chronic venous congestion and its detrimental effect on end-organ function is better understood ( 4 ). These patients are not usually favored for surgical valvotomy or valvular replacement due to perceived high surgical risk that is attributed to poor functional status, underlying disease process, recurrent exacerbations, and significant comorbidities.…”

Section: Introductionmentioning

confidence: 99%

Restructuring the Heart From Failure to Success: Role of Structural Interventions in the Realm of Heart Failure

Kir

Munagala

2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

Heart failure through the spectrum of reduced (HFrEF), mid-range (or mildly reduced or HFmEF), and preserved ejection fraction (HFpEF), continues to plague patients' quality of life through recurrent admissions and high mortality rates. Despite tremendous innovation in medical therapy, patients continue to experience refractory congestive symptoms due to adverse left ventricular remodeling, significant functional mitral regurgitation (FMR), and right-sided failure symptoms due to significant functional tricuspid regurgitation (FTR). As most of these patients are surgically challenging for open cardiac surgery, the past decade has seen the development and evolution of different percutaneous structural interventions targeted at improving FMR and FTR. There is renewed interest in the sphere of left ventricular restorative devices to effect reverse remodeling and thereby improve effective stroke volume and patient outcomes. For patients suffering from HFpEF, there is still a paucity of disease-modifying effective medical therapies, and these patients continue to have recurrent heart failure exacerbations due to impaired left ventricular relaxation and high filling pressures. Structural therapies involving the implantation of inter-atrial shunt devices to decrease left atrial pressure and the development of implantable devices in the pulmonary artery for real-time hemodynamic monitoring would help redefine treatment and outcomes for patients with HFpEF. Lastly, there is pre-clinical data supportive of soft robotic cardiac sleeves that serve to improve cardiac function, can assist contraction as well as relaxation of the heart, and have the potential to be customized for each patient. In this review, we focus on the role of structural interventions in heart failure as it stands in current clinical practice, evaluate the evidence amassed so far, and review promising structural therapies that may transform the future of heart failure management.

show abstract

Secondary Tricuspid Regurgitation: Pathophysiology, Incidence and Prognosis

Cited by 18 publications

References 42 publications

Tricuspid Annulus Dilation in Patients With Combined Functional Tricuspid Regurgitation and Left-Heart Valvular Disease: Does Septal Annulus Not Dilate?

Tricuspid Annulus Dilation in Patients With Combined Functional Tricuspid Regurgitation and Left-Heart Valvular Disease: Does Septal Annulus Not Dilate?

Echocardiography Imaging of the Right Ventricle: Focus on Three-Dimensional Echocardiography

Restructuring the Heart From Failure to Success: Role of Structural Interventions in the Realm of Heart Failure

Contact Info

Product

Resources

About