Exercise intolerance in severe tricuspid regurgitation is hemodynamically driven by low cardiac output reserve and elevated bilateral filling pressures due to ventricular interaction.
Supports exercise hemodynamic assessment in severe TR; leaves open whether targeting ventricular interaction improves outcomes.
Impaired exercise capacity in people with severe TR is related to low cardiac output reserve relative to metabolic needs, coupled with elevated systemic and pulmonary venous pressures. Left heart pressures are elevated with exercise in subjects with TR, despite low LV preload, secondary to enhanced ventricular interaction.
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Andersen et al. (2014) studied this question.
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