Cohort study

Atrial Functional Tricuspid Regurgitation

JACC Cardiovasc ImagingPublished

  • Retrospective cohort study

Authors' conclusion

In patients with mild TR, significant AFTR developed predominantly in patients with AF-AFL, conferring poor prognosis. RA enlargement, especially with increased RA area-to-right ventricle end-systolic area ratio, was a strong risk factor for progression of AFTR.

Study context

Population
Patients with mild TR with follow-up echocardiography
Participants
833 patients
Exposure
Atrial fibrillation-flutter (AF-AFL) vs no AF-AFL
  • AF-AFLn = 291
Outcome
Development of significant (≥ moderate) atrial functional TR (AFTR)
Follow-up
Median 4.6 years

Main finding

Significant AFTR

Adjusted hazard ratio

8.33

95% CI 2.34–29.69

P = 0.001

By group

AF-AFL vs No AF-AFL
adjusted HR 8.33 (95% CI 2.34–29.69); P = 0.001

As reported in the abstract

Significant TR developed (33 atrial functional tricuspid regurgitation (AFTRs))
35

Observational data: associations, not effects.

Further findings

Baseline right atrial (RA) area, AF-AFL patients developing vs not developing significant AFTR

RA area 23.8 vs 19.4 cm²
P < 0.001
RA area-to-RV end-systolic area ratio 3.0 vs 2.3
P < 0.001
These parameters were independent predictors of AFTR progression

10-year MACE after vs before or without AFTR progression

79.8% vs 8.6%
Mantel-Byar P < 0.001

Original publication

Atrial Functional Tricuspid Regurgitation. JACC Cardiovasc Imaging. Published 11 January 2023. doi:10.1016/j.jcmg.2022.11.014

Summarised from the published abstract; every number is checked against it