Cardiac remodelling in secondary tricuspid regurgitation: Should we look beyond the tricuspid annulus diameter?
Aged
Aged, 80 and over
Atrial Function, Right
Atrial Remodeling
Echocardiography, Doppler, Color
Echocardiography, Doppler, Pulsed
Female
France
Hemodynamics
Humans
Male
Middle Aged
Prognosis
Prospective Studies
Registries
Severity of Illness Index
Tricuspid Valve
/ diagnostic imaging
Tricuspid Valve Insufficiency
/ diagnostic imaging
Ventricular Function, Right
Ventricular Remodeling
Determinant
Déterminant
Insuffisance tricuspide
Remodelage du ventricule droit
Right heart remodelling
Tricuspid regurgitation
Journal
Archives of cardiovascular diseases
ISSN: 1875-2128
Titre abrégé: Arch Cardiovasc Dis
Pays: Netherlands
ID NLM: 101465655
Informations de publication
Date de publication:
Apr 2021
Apr 2021
Historique:
received:
21
06
2020
revised:
20
09
2020
accepted:
17
11
2020
pubmed:
16
1
2021
medline:
2
6
2021
entrez:
15
1
2021
Statut:
ppublish
Résumé
A better understanding of the mechanism of tricuspid regurgitation severity would help to improve the management of this disease. We sought to characterize the determinants of isolated secondary tricuspid regurgitation severity in patients with preserved left ventricular ejection fraction. This was a prospective observational multicentre study. Patients with severe tricuspid regurgitation were asked to participate in a registry that required a control echocardiogram after optimization of medical treatment and a follow-up. Patients had to have at least mild secondary tricuspid regurgitation when clinically stable, and were classified according to five grades of tricuspid regurgitation severity, based on effective regurgitant orifice area. One hundred patients with tricuspid regurgitation (12 mild, 31 moderate, 18 severe, 17 massive and 22 torrential) were enrolled. Right atrial indexed volume and tethering area were statistically associated with the degree of tricuspid regurgitation (P<0.001 and P=0.005, respectively). When the tricuspid annular diameter was≥50mm, the probability of having severe tricuspid regurgitation or a higher grade was>70%. For an increase of 10mL/m For tricuspid regurgitation to be severe or torrential, both right atrial dilatation and leaflet tethering are needed. Interestingly, right cavities dilated progressively with tricuspid regurgitation severity, without joint degradation of right ventricular systolic function variables.
Sections du résumé
BACKGROUND
BACKGROUND
A better understanding of the mechanism of tricuspid regurgitation severity would help to improve the management of this disease.
AIM
OBJECTIVE
We sought to characterize the determinants of isolated secondary tricuspid regurgitation severity in patients with preserved left ventricular ejection fraction.
METHODS
METHODS
This was a prospective observational multicentre study. Patients with severe tricuspid regurgitation were asked to participate in a registry that required a control echocardiogram after optimization of medical treatment and a follow-up. Patients had to have at least mild secondary tricuspid regurgitation when clinically stable, and were classified according to five grades of tricuspid regurgitation severity, based on effective regurgitant orifice area.
RESULTS
RESULTS
One hundred patients with tricuspid regurgitation (12 mild, 31 moderate, 18 severe, 17 massive and 22 torrential) were enrolled. Right atrial indexed volume and tethering area were statistically associated with the degree of tricuspid regurgitation (P<0.001 and P=0.005, respectively). When the tricuspid annular diameter was≥50mm, the probability of having severe tricuspid regurgitation or a higher grade was>70%. For an increase of 10mL/m
CONCLUSIONS
CONCLUSIONS
For tricuspid regurgitation to be severe or torrential, both right atrial dilatation and leaflet tethering are needed. Interestingly, right cavities dilated progressively with tricuspid regurgitation severity, without joint degradation of right ventricular systolic function variables.
Identifiants
pubmed: 33446476
pii: S1875-2136(20)30263-1
doi: 10.1016/j.acvd.2020.11.002
pii:
doi:
Types de publication
Journal Article
Multicenter Study
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
277-286Informations de copyright
Copyright © 2021 Elsevier Masson SAS. All rights reserved.