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Atrial functional tricuspid regurgitation: a novel and underappreciated clinical entity Cover

Atrial functional tricuspid regurgitation: a novel and underappreciated clinical entity

Romanian Journal of Cardiology
Volume 31 (2021): Issue 1 (March 2021)
By: Diana-Ruxandra Florescu,  Stefano Figliozzi,  Andrada Guta,  Stefano Vicini,  Michele Tomaselli,  Georgică Costinel Târtea,  Octavian Istrătoaie,  Gianfranco Parati,  Luigi Badano and  Denisa Muraru  
Open Access
|Apr 2022

Figures & Tables

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
DOI: https://doi.org/10.47803/rjc.2021.31.1.27 | Journal eISSN: 2734-6382 | Journal ISSN: 1220-658X
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Language: English
Page range: 27 - 35
Published on: Apr 30, 2022
Published by: Romanian Society of Cardiology
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year
Keywords:
atrial functional tricuspid regurgitation,
tricuspid valve,
three-dimensional echocardiography,
transthoracic echocardiography
Related subjects:
Medicine,
Clinical medicine,
Internal medicine,
Cardiology,
Pediatrics and juvenile medicine,
Paediatric cardiology,
Surgery,
Cardiac surgery

© 2022 Diana-Ruxandra Florescu, Stefano Figliozzi, Andrada Guta, Stefano Vicini, Michele Tomaselli, Georgică Costinel Târtea, Octavian Istrătoaie, Gianfranco Parati, Luigi Badano, Denisa Muraru, published by Romanian Society of Cardiology
This work is licensed under the Creative Commons Attribution 4.0 License.

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