Related Experiment Video
Updated: Jul 20, 2026
07:11
Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography
Published on: October 28, 2020
2.8K
Atrial Functional Tricuspid Regurgitation: Contemporary Characteristics, Outcomes, and Novel Risk Score
Agostina M Fava1, Michael Nakhla1, Adel Hajj Ali1
1Department of Cardiovascular Medicine, Sydell and Arnold Miller Heart, Vascular, and Thoracic Institute, Cleveland, Ohio, USA.
JACC. Advances
|February 26, 2025
Summary
Atrial functional tricuspid regurgitation (AF-TR) is associated with poor prognosis, particularly with an effective regurgitant orifice area ≥0.40 cm². A new risk score aids in stratifying 1-year mortality risk for AF-TR patients.
Area of Science:
- Cardiology
- Cardiac Surgery
- Echocardiography
Background:
- Limited literature exists on atrial functional tricuspid regurgitation (AF-TR) characteristics and outcomes.
- Increasing clinical recognition highlights the need for better understanding of this valve lesion.
Purpose of the Study:
- To determine clinical and echocardiographic characteristics of AF-TR.
- To analyze outcomes and identify adverse prognosticators in a large AF-TR cohort.
- To develop a novel risk model for predicting mortality in AF-TR patients.
Main Methods:
- Retrospective study of 370 patients with moderate-to-severe AF-TR (2004-2018).
- Used logistic regression to identify risk factors for 1-year all-cause mortality.
- Developed and validated a novel risk score.
Main Results:
- 1-year mortality was 21.9%, with 59.2% total mortality.
- Key predictors of 1-year mortality included right heart failure, low serum albumin, high right atrial volume, low TAPSE/RVSP ratio, and high TR-EROA.
- The derived risk model demonstrated good predictive discrimination (AUC: 0.87).
Conclusions:
- Patients with AF-TR face a poor prognosis, especially those with TR-EROA ≥0.40 cm².
- A novel risk score was developed for 1-year mortality prediction in AF-TR.
- The risk score may aid in patient stratification and treatment guidance, pending external validation.
Related Concept Videos
01:20Mitral Regurgitation I: Introduction
Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
01:23Mitral Regurgitation II: Clinical Features and Diagnostic Tests
Mitral regurgitation (MR) is a valvular heart disorder in which the mitral valve fails to close tightly, allowing blood to leak backward into the heart. Understanding the clinical manifestations, assessment, diagnostic findings, and medical management of MR is crucial to effectively managing affected patients.Clinical Manifestations of Mitral RegurgitationMitral regurgitation can be acute or chronic, each presenting differently and requiring different approaches:1. Acute Mitral...
01:25Mitral Regurgitation III: Medical Management
Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
01:15Aortic Regurgitation I: Introduction
IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
01:22Aortic Regurgitation II: Clinical Features and Diagnostic Tests
Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
01:25Aortic Regurgitation III: Medical Management
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...