Atrial secondary tricuspid regurgitation : Pathophysiology, definition, diagnosis, and treatment
Muraru, Denisa (Istituto Auxologico Italiano)
Badano, Luigi P. (Istituto Auxologico Italiano)
Hahn, Rebecca T. (Columbia University Irving Medical Center)
Lang, Roberto M. (University of Chicago Medical Center)
Delgado, Victoria (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Wunderlich, Nina C. (Asklepios Klinik Langen (Alemanya))
Donal, Erwan (University of Rennes 1)
Taramasso, Maurizio (HerzZentrum Hirslanden Zürich)
Duncan, Alison (Royal Brompton Hospital (Londres))
Lurz, Philipp (Universitätsmedizin Johannes Gutenberg-University)
De Potter, Tom (OLV Hospital (Bèlgica))
Zamorano, José Luis (Hospital Universitario Ramón y Cajal (Madrid))
Bax, Jeroen J. (Leiden University Medical Center)
Von Bardeleben, Ralph Stephan (Universitätsmedizin Johannes Gutenberg-University)
Enriquez-Sarano, Maurizio (Minneapolis Heart Institute Foundation)
Maisano, Francesco (University Vita Salute (Milà, Itàlia))
Praz, Fabien (University of Bern)
Sitges, Marta (Centro de Investigación Biomèdica en Red (Barcelona))

Data:	2024
Resum:	Atrial secondary tricuspid regurgitation (A-STR) is a distinct phenotype of secondary tricuspid regurgitation with predominant dilation of the right atrium and normal right and left ventricular function. Atrial secondary tricuspid regurgitation occurs most commonly in elderly women with atrial fibrillation and in heart failure with preserved ejection fraction in sinus rhythm. In A-STR, the main mechanism of leaflet malcoaptation is related to the presence of a significant dilation of the tricuspid annulus secondary to right atrial enlargement. In addition, there is an insufficient adaptive growth of tricuspid valve leaflets that become unable to cover the enlarged annular area. As opposed to the ventricular phenotype, in A-STR, the tricuspid valve leaflet tethering is typically trivial. The A-STR phenotype accounts for 10%-15% of clinically relevant tricuspid regurgitation and has better outcomes compared with the more prevalent ventricular phenotype. Recent data suggest that patients with A-STR may benefit from more aggressive rhythm control and timely valve interventions. However, little is mentioned in current guidelines on how to identify, evaluate, and manage these patients due to the lack of consistent evidence and variable definitions of this entity in recent investigations. This interdisciplinary expert opinion document focusing on A-STR is intended to help physicians understand this complex and rapidly evolving topic by reviewing its distinct pathophysiology, diagnosis, and multi-modality imaging characteristics. It first defines A-STR by proposing specific quantitative criteria for defining the atrial phenotype and for discriminating it from the ventricular phenotype, in order to facilitate standardization and consistency in research.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article de revisió ; recerca ; Versió publicada
Matèria:	Tricuspid valve ; Tricuspid regurgitation ; Atrial functional tricuspid regurgitation ; Secondary tricuspid regurgitation ; Atrial fibrillation ; Transcatheter interventions
Publicat a:	European heart journal, Vol. 45 Núm. 11 (14 2024) , p. 895-911, ISSN 1522-9645

DOI: 10.1093/eurheartj/ehae088
PMID: 38441886

17 p, 1.6 MB

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Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
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