Descriptive analysis of mitral and tricuspid annular parameters in non-valvular atrial fibrillation

The objective was to describe mitral and tricuspid annular parameters by regurgitation severity within non-valvular atrial fibrillation (NVAF), emphasizing estimation precision, with secondary clinical-comparator analyses. In this retrospective cross-sectional study, 190 records from a 2024–2025 echocardiography record set were assessed; 4 were excluded and 96 NVAF and 90 patent foramen ovale (PFO)-evaluation comparator records were included. Recorded maximal and minimal annular areas, recorded annular height (AHmax), and area change fraction (ACF) were analyzed. ACF required complete valid area pairs. Mean differences with 95% confidence intervals (CIs) were calculated using Welch tests; matched comparisons used complete pairs and paired tests. Within NVAF, mean differences (moderate-or-greater minus less-than-moderate regurgitation; 95% CIs) were − 0.28 (− 0.64 to 0.08) mm for mitral AH max and − 0.31 (− 2.32 to 1.71) percentage points for mitral ACF. Corresponding tricuspid differences were − 0.28 (− 0.64 to 0.07) mm and − 1.08 (− 3.52 to 1.36) percentage points. Mitral areas were larger in the 14 patients with moderate-or-greater mitral regurgitation. Effective ACF sample sizes in NVAF were 92 and 91 for the mitral and tricuspid annuli. Quantitative grading was complete in 42 mitral and 34 tricuspid cases. Between-cohort contrasts were accompanied by substantial baseline imbalance and incomplete acquisition metadata. Within-NVAF recorded AHmax and ACF estimates were imprecise and did not establish equivalence. Tricuspid findings remain exploratory; recorded AHmax cannot establish three-dimensional non-planarity. Between-cohort contrasts cannot distinguish biological variation from differences in measurement or clinical context. Prospective studies with documented acquisition protocols, complete regurgitation grading, and longitudinal three-dimensional imaging are needed.