Why the study?
Atrial functional tricuspid regurgitation has emerged as a distinct pathophysiological entity from ventricular functional tricuspid regurgitation, posing different clinical management needs and considerations for transcatheter interventions and imaging.
This review highlights atrial functional tricuspid regurgitation as a distinct entity from ventricular FTR, emphasizing the need for tailored transcatheter interventions and imaging strategies.
FTR's independent prognostic value warrants routine TV assessment in RV disease; leaves open optimal timing and patient selection for transcatheter intervention.
Functional tricuspid regurgitation (FTR) is a strong and independent predictor of patient morbidity and mortality if left untreated. The development of transcatheter procedures to either repair or replace the tricuspid valve (TV) has fueled the interest in the pathophysiology, severity assessment, and clinical consequences of FTR. FTR has been considered to be secondary to tricuspid annulus (TA) dilation and leaflet tethering, associated to right ventricular (RV) dilation and/or dysfunction (the "classical", ventricular form of FTR, V-FTR) for a long time. Atrial FTR (A-FTR) has recently emerged as a distinct pathophysiological entity. A-FTR typically occurs in patients with persistent/permanent atrial fibrillation, in whom an imbalance between the TA and leaflet areas results in leaflets malcoaptation, associated with the dilation and loss of the sphincter-like function of the TA, due to right atrium enlargement and dysfunction. According to its distinct pathophysiology, A-FTR poses different needs of clinical management, and the various interventional treatment options will likely have different outcomes than in V-FTR patients. This review aims to provide an insight into the anatomy of the TV, and the distinct pathophysiology of A-FTR, which are key concepts to understanding the objectives of therapy, the choice of transcatheter TV interventions, and to properly use pre-, intra-, and post-procedural imaging.
No takes yet. Share an insight, caveat, or question.
Florescu et al. (2022) studied this question.