Clinical and Echocardiographic Factors Affecting Tricuspid Regurgitation Severity in the Patients with Lone Atrial Fibrillation
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Background: Atrial fibrillation (AF) can be a risk factor for development of significant tricuspid regurgitation (TR). We investigatedwhich 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 patientswith moderate TR, and 40 consecutive patients with less than mild TR. Clinical parameters and echocardiographic measurementsincluding 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 relatedto right atrial area and tricuspid annular systolic diameter (all p < 0.001). The patients with moderate or severe TR hadlarger left atrial (LA) volume and increased systolic pulmonary artery pressure (SPAP) than the patients with mild TR (p = 0.04for LA volume; p < 0.001 for SPAP). RV remodeling represented by enlarged RV area and increased tenting height was moreprominent in severe TR than mild or moderate TR (all p < 0.001). Multivariate analysis showed type of AF, LA volume, tricuspidannular diameter and tenting height remained as a significant determinants of severe TR. In addition, tenting height was independentlyassociated 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.
Abstract
Background: Atrial fibrillation (AF) can be a risk factor for development of significant tricuspid regurgitation (TR). We investigatedwhich 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 patientswith moderate TR, and 40 consecutive patients with less than mild TR. Clinical parameters and echocardiographic measurementsincluding 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 relatedto right atrial area and tricuspid annular systolic diameter (all p < 0.001). The patients with moderate or severe TR hadlarger left atrial (LA) volume and increased systolic pulmonary artery pressure (SPAP) than the patients with mild TR (p = 0.04for LA volume; p < 0.001 for SPAP). RV remodeling represented by enlarged RV area and increased tenting height was moreprominent in severe TR than mild or moderate TR (all p < 0.001). Multivariate analysis showed type of AF, LA volume, tricuspidannular diameter and tenting height remained as a significant determinants of severe TR. In addition, tenting height was independentlyassociated 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.
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