Valvular & structural heart disease
Atrial Functional Tricuspid Regurgitation: Importance of Atrial Fibrillation and Right Atrial Remodeling and Prognostic Significance
Main finding · Significant AFTRResult — go to the resultAdjusted hazard ratio 8.33 95% CI 2.34–29.69Authors' 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-AFLvs 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: Importance of Atrial Fibrillation and Right Atrial Remodeling and Prognostic Significance. JACC Cardiovasc Imaging. Published 11 January 2023. doi:10.
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