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Atrial functional tricuspid regurgitation: a novel and underappreciated clinical entity

Diana-Ruxandra Florescu
Diana-Ruxandra Florescu
, 
Stefano Figliozzi
Stefano Figliozzi
, 
Andrada Guta
Andrada Guta
, 
Stefano Vicini
Stefano Vicini
, 
Michele Tomaselli
Michele Tomaselli
, 
Georgică Costinel Târtea
Georgică Costinel Târtea
, 
Octavian Istrătoaie
Octavian Istrătoaie
, 
Gianfranco Parati
Gianfranco Parati
, 
Luigi Badano
Luigi Badano
 et 
Denisa Muraru
Denisa Muraru
   | 30 avr. 2022
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Article Category: Review
Publié en ligne: 30 avr. 2022
Pages: 27 - 35
DOI: https://doi.org/10.47803/rjc.2021.31.1.27
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© 2021 Diana-Ruxandra Florescu et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.

Figure 1

Comparison between atrial and ventricular functional tricuspid regurgitation; adapted from 5.
Comparison between atrial and ventricular functional tricuspid regurgitation; adapted from 5.

Figure 2

Atrial functional tricuspid regurgitation: RV-focused apical four-chamber color flow of the regurgitant jet (A); En face view of the tricuspid valve by 3D echocardiography (B); Tricuspid annulus geometry (C) and measurements (D) by 4D Auto TVQ software (GE Healthcare, Horten, N).
Atrial functional tricuspid regurgitation: RV-focused apical four-chamber color flow of the regurgitant jet (A); En face view of the tricuspid valve by 3D echocardiography (B); Tricuspid annulus geometry (C) and measurements (D) by 4D Auto TVQ software (GE Healthcare, Horten, N).

Figure 3

Ventricular functional tricuspid regurgitation in a patient with pulmonary hypertension. RV-focused apical four-chamber color flow of the regurgitant jet (A); En face view of the tricuspid valve by three-dimensional echocardiography (B); Tricuspid annulus geometry (C) and measurements (D) by 4D Auto TVQ software (GE Healthcare, Horten, N). Note the significant leaflet tethering (coaptation point height, tenting volume) with respect to Figure 2.
Ventricular functional tricuspid regurgitation in a patient with pulmonary hypertension. RV-focused apical four-chamber color flow of the regurgitant jet (A); En face view of the tricuspid valve by three-dimensional echocardiography (B); Tricuspid annulus geometry (C) and measurements (D) by 4D Auto TVQ software (GE Healthcare, Horten, N). Note the significant leaflet tethering (coaptation point height, tenting volume) with respect to Figure 2.

Figure 4

Atrial functional tricuspid regurgitation and quantification of its severity: RV-focused apical four-chamber view showing dilated right atrium and tricuspid annulus, with relatively preserved right ventricular size and no leaflet tethering (A); Velocity time integral (TR VTI) of tricuspid regurgitation CW Doppler jet (B) and 2D PISA radius measurement (C) allowing to calculate the effective regurgitant orifice area (TR ERO) and regurgitant volume (TR RV).
Atrial functional tricuspid regurgitation and quantification of its severity: RV-focused apical four-chamber view showing dilated right atrium and tricuspid annulus, with relatively preserved right ventricular size and no leaflet tethering (A); Velocity time integral (TR VTI) of tricuspid regurgitation CW Doppler jet (B) and 2D PISA radius measurement (C) allowing to calculate the effective regurgitant orifice area (TR ERO) and regurgitant volume (TR RV).

Figure 5

Comparison of the coaptation of the tricuspid leaflets in normal subjects, with the leaflets coapting along the leaflet’s body and in the plane of the tricuspid annulus (left panel); coaptation in pulmonary hypertension patients, with the leaflets coaptation occurring along the leaflets’ free edge and being apically displaced (ventricular functional tricuspid regurgitation, middle panel); coaptation in atrial fibrillation patients with reduced leaflet apposition due to significant annular dilation (atrial functional tricuspid regurgitation, right panel). Abbreviations: FTR, functional tricuspid regurgitation; RA, right atrium; RV, right ventricle
Comparison of the coaptation of the tricuspid leaflets in normal subjects, with the leaflets coapting along the leaflet’s body and in the plane of the tricuspid annulus (left panel); coaptation in pulmonary hypertension patients, with the leaflets coaptation occurring along the leaflets’ free edge and being apically displaced (ventricular functional tricuspid regurgitation, middle panel); coaptation in atrial fibrillation patients with reduced leaflet apposition due to significant annular dilation (atrial functional tricuspid regurgitation, right panel). Abbreviations: FTR, functional tricuspid regurgitation; RA, right atrium; RV, right ventricle
eISSN:
2734-6382
Langue:
Anglais
Périodicité:
4 fois par an
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Medicine, Clinical Medicine, Internal Medicine, Cardiology, Pediatrics and Juvenile Medicine, Paediatric Cardiology, Surgery, Cardiac Surgery
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