Atrial Functional Tricuspid Regurgitation as a Distinct Pathophysiological and Clinical Entity: No Idiopathic Tricuspid Regurgitation Anymore
Functional tricuspid regurgitation (FTR) is a strong and independent predictor of patient morbidity and mortality if left untreated. The development of transcatheter procedures to either repair or replace the tricuspid valve (TV) has fueled the interest in the pathophysiology, severity assessment, a...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-01-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/2/382 |
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| author | Diana R. Florescu Denisa Muraru Valentina Volpato Mara Gavazzoni Sergio Caravita Michele Tomaselli Pellegrino Ciampi Cristina Florescu Tudor A. Bălșeanu Gianfranco Parati Luigi P. Badano |
| author_facet | Diana R. Florescu Denisa Muraru Valentina Volpato Mara Gavazzoni Sergio Caravita Michele Tomaselli Pellegrino Ciampi Cristina Florescu Tudor A. Bălșeanu Gianfranco Parati Luigi P. Badano |
| author_sort | Diana R. Florescu |
| collection | DOAJ |
| description | Functional tricuspid regurgitation (FTR) is a strong and independent predictor of patient morbidity and mortality if left untreated. The development of transcatheter procedures to either repair or replace the tricuspid valve (TV) has fueled the interest in the pathophysiology, severity assessment, and clinical consequences of FTR. FTR has been considered to be secondary to tricuspid annulus (TA) dilation and leaflet tethering, associated to right ventricular (RV) dilation and/or dysfunction (the “classical”, ventricular form of FTR, V-FTR) for a long time. Atrial FTR (A-FTR) has recently emerged as a distinct pathophysiological entity. A-FTR typically occurs in patients with persistent/permanent atrial fibrillation, in whom an imbalance between the TA and leaflet areas results in leaflets malcoaptation, associated with the dilation and loss of the sphincter-like function of the TA, due to right atrium enlargement and dysfunction. According to its distinct pathophysiology, A-FTR poses different needs of clinical management, and the various interventional treatment options will likely have different outcomes than in V-FTR patients. This review aims to provide an insight into the anatomy of the TV, and the distinct pathophysiology of A-FTR, which are key concepts to understanding the objectives of therapy, the choice of transcatheter TV interventions, and to properly use pre-, intra-, and post-procedural imaging. |
| first_indexed | 2024-03-10T01:13:16Z |
| format | Article |
| id | doaj.art-878fa3fdd6854060a9a55a53fcd2eb12 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T01:13:16Z |
| publishDate | 2022-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-878fa3fdd6854060a9a55a53fcd2eb122023-11-23T14:13:01ZengMDPI AGJournal of Clinical Medicine2077-03832022-01-0111238210.3390/jcm11020382Atrial Functional Tricuspid Regurgitation as a Distinct Pathophysiological and Clinical Entity: No Idiopathic Tricuspid Regurgitation AnymoreDiana R. Florescu0Denisa Muraru1Valentina Volpato2Mara Gavazzoni3Sergio Caravita4Michele Tomaselli5Pellegrino Ciampi6Cristina Florescu7Tudor A. Bălșeanu8Gianfranco Parati9Luigi P. Badano10Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaDepartment of Cardiology, Istituto Auxologico Italiano, IRCCS, 20145 Milan, ItalyDepartment of Cardiology, Istituto Auxologico Italiano, IRCCS, 20145 Milan, ItalyDepartment of Cardiology, Istituto Auxologico Italiano, IRCCS, 20145 Milan, ItalyDepartment of Cardiology, Istituto Auxologico Italiano, IRCCS, 20145 Milan, ItalyDepartment of Cardiology, Istituto Auxologico Italiano, IRCCS, 20145 Milan, ItalyDepartment of Cardiology, Istituto Auxologico Italiano, IRCCS, 20145 Milan, ItalyFaculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaFaculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaDepartment of Cardiology, Istituto Auxologico Italiano, IRCCS, 20145 Milan, ItalyDepartment of Cardiology, Istituto Auxologico Italiano, IRCCS, 20145 Milan, ItalyFunctional tricuspid regurgitation (FTR) is a strong and independent predictor of patient morbidity and mortality if left untreated. The development of transcatheter procedures to either repair or replace the tricuspid valve (TV) has fueled the interest in the pathophysiology, severity assessment, and clinical consequences of FTR. FTR has been considered to be secondary to tricuspid annulus (TA) dilation and leaflet tethering, associated to right ventricular (RV) dilation and/or dysfunction (the “classical”, ventricular form of FTR, V-FTR) for a long time. Atrial FTR (A-FTR) has recently emerged as a distinct pathophysiological entity. A-FTR typically occurs in patients with persistent/permanent atrial fibrillation, in whom an imbalance between the TA and leaflet areas results in leaflets malcoaptation, associated with the dilation and loss of the sphincter-like function of the TA, due to right atrium enlargement and dysfunction. According to its distinct pathophysiology, A-FTR poses different needs of clinical management, and the various interventional treatment options will likely have different outcomes than in V-FTR patients. This review aims to provide an insight into the anatomy of the TV, and the distinct pathophysiology of A-FTR, which are key concepts to understanding the objectives of therapy, the choice of transcatheter TV interventions, and to properly use pre-, intra-, and post-procedural imaging.https://www.mdpi.com/2077-0383/11/2/382tricuspid regurgitationatrial functional tricuspid regurgitationtranscatheter tricuspid valve interventionsechocardiographythree-dimensional echocardiographymultimodality imaging |
| spellingShingle | Diana R. Florescu Denisa Muraru Valentina Volpato Mara Gavazzoni Sergio Caravita Michele Tomaselli Pellegrino Ciampi Cristina Florescu Tudor A. Bălșeanu Gianfranco Parati Luigi P. Badano Atrial Functional Tricuspid Regurgitation as a Distinct Pathophysiological and Clinical Entity: No Idiopathic Tricuspid Regurgitation Anymore Journal of Clinical Medicine tricuspid regurgitation atrial functional tricuspid regurgitation transcatheter tricuspid valve interventions echocardiography three-dimensional echocardiography multimodality imaging |
| title | Atrial Functional Tricuspid Regurgitation as a Distinct Pathophysiological and Clinical Entity: No Idiopathic Tricuspid Regurgitation Anymore |
| title_full | Atrial Functional Tricuspid Regurgitation as a Distinct Pathophysiological and Clinical Entity: No Idiopathic Tricuspid Regurgitation Anymore |
| title_fullStr | Atrial Functional Tricuspid Regurgitation as a Distinct Pathophysiological and Clinical Entity: No Idiopathic Tricuspid Regurgitation Anymore |
| title_full_unstemmed | Atrial Functional Tricuspid Regurgitation as a Distinct Pathophysiological and Clinical Entity: No Idiopathic Tricuspid Regurgitation Anymore |
| title_short | Atrial Functional Tricuspid Regurgitation as a Distinct Pathophysiological and Clinical Entity: No Idiopathic Tricuspid Regurgitation Anymore |
| title_sort | atrial functional tricuspid regurgitation as a distinct pathophysiological and clinical entity no idiopathic tricuspid regurgitation anymore |
| topic | tricuspid regurgitation atrial functional tricuspid regurgitation transcatheter tricuspid valve interventions echocardiography three-dimensional echocardiography multimodality imaging |
| url | https://www.mdpi.com/2077-0383/11/2/382 |
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