J Cardiovasc Ultrasound.  2015 Sep;23(3):136-142. 10.4250/jcu.2015.23.3.136.

Clinical and Echocardiographic Factors Affecting Tricuspid Regurgitation Severity in the Patients with Lone Atrial Fibrillation

Affiliations
  • 1Division of Cardiology, Department of Internal Medicine, Inha University Hospital, Incheon, Korea. sshin@inha.ac.kr

Abstract

BACKGROUND
Atrial fibrillation (AF) can be a risk factor for development of significant tricuspid regurgitation (TR). We investigated which clinical and echocardiographic parameters were related to severity of functional TR in patients with lone AF.
METHODS
A total of 89 patients with lone AF were enrolled (75 +/- 11 years; 48% male): 13 patients with severe TR, 36 patients with moderate TR, and 40 consecutive patients with less than mild TR. Clinical parameters and echocardiographic measurements including right ventricular (RV) remodeling and function were evaluated.
RESULTS
Patients with more severe TR were older and had more frequently persistent AF (each p < 0.001). TR severity was related to right atrial area and tricuspid annular systolic diameter (all p < 0.001). The patients with moderate or severe TR had larger left atrial (LA) volume and increased systolic pulmonary artery pressure (SPAP) than the patients with mild TR (p = 0.04 for LA volume; p < 0.001 for SPAP). RV remodeling represented by enlarged RV area and increased tenting height was more prominent in severe TR than mild or moderate TR (all p < 0.001). Multivariate analysis showed type of AF, LA volume, tricuspid annular diameter and tenting height remained as a significant determinants of severe TR. In addition, tenting height was independently associated with the presence of severe TR (p = 0.04).
CONCLUSION
In patients with lone AF, TR was related to type of AF, LA volume, tricuspid annular diameter and RV remodeling. Especially, tricuspid valvular tethering seemed to be independently associated with development of severe functional TR.

Keyword

Tricuspid regurgitation; Atrial fibrillation; Tenting height

MeSH Terms

Atrial Fibrillation*
Echocardiography*
Humans
Multivariate Analysis
Pulmonary Artery
Risk Factors
Tricuspid Valve Insufficiency*

Figure

  • Fig. 1 Relationship between tenting height and RAA (A), RVESA (B), TV annulus (C), and RV spherical index (D). RAA: right atrial area, RV: right ventricle, RVESA: right ventricular end-systolic area, TV: tricuspid valve.

  • Fig. 2 Relationship between vena contracta and age (A), LAV (B), TV annulus (C), and tenting height (D). LAV: left atrial volume, TV: tricuspid valve


Cited by  2 articles

Tricuspid Regurgitation, Isn't It Time to Look Around the Valve Rather Than the Valve Itself?
Seung-Pyo Lee
J Cardiovasc Ultrasound. 2015;23(3):134-135.    doi: 10.4250/jcu.2015.23.3.134.

Current Unmet Needs and Clues to the Solution in the Management of Tricuspid Regurgitation
Byung Joo Sun, Jae-Hyeong Park
Korean Circ J. 2022;52(6):414-428.    doi: 10.4070/kcj.2022.0117.


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