What are the clinical and echocardiographic differences between functional tricuspid regurgitation caused by chronic atrial fibrillation and left-sided heart disease?
Functional TR secondary to chronic AF is associated with right atrial enlargement and annular dilatation without leaflet deformation, suggesting TV annuloplasty may be an effective treatment.
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: ; 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.
Utsunomiya et al. (Sun,) studied this question.