Markedly enlarged rigth atrium associated with physical signs of tricuspid regurgitation. A Cause of Congestive Heart Failure in the Elderly.

Clinical Context and Mechanism of Functional Tricuspid Regurgitation in Patients With and Without Pulmonary Hypertension

“…The Id-FTR entity is not well-known, not only mechanistically but also clinically, and awareness of its existence was raised by few seminal reports. 9,11,12,14 Although our data highlight Id-FTR exhaustion of valvular reserve in covering the enlarged tricuspid annulus, the cause of annular enlargement remains uncertain. AFib association suggests links to atrial enlargement, 11 but Id-FTR also occurs in sinus rhythm, and its link to aging may reflect annular degeneration.…”

“…8 Accruing reports noted FTR with normal pulmonary pressure 9 and without overt cause, despite comprehensive workup, 10 referred as idiopathic FTR (Id-FTR). 9,[11][12][13][14] Id-FTR prevalence, clinical context, and mechanisms are unknown, underscoring the general need for better FTR mechanism understanding. 1 Previous studies implicated various candidate FTR mechanisms, annular 3,15,16 or valvular, 16,17 but uncertainty persists on processes yielding FTR, particularly when severe.…”

Impact of Atrial Fibrillation on Tricuspid and Mitral Annular Dilatation and Valvular Regurgitation.

“…[22][23][24][25] In the present study, moderate TR with significant annular dilatation but without organic leaflet lesions was frequently observed in patients with lone AF and may be the early stage of isolated severe TR in the elderly, suggesting AF is a potential determinant of such TR. Further studies are necessary to evaluate the progressive deterioration of TR in patients with AF.…”

“…Other investigations have also reported patients with isolated severe TR with annular dilatation but without organic leaflet lesions. [22][23][24][25] Together, these findings suggest that careful evaluation and follow up of tricuspid valve function is necessary in patients with lone AF. It should also be taken into consideration when determining the indications for tricuspid annuloplasty or surgical intervention in patients with mild to moderate TR.…”

Plasma Levels of Brain Natriuretic Peptide Increase in Patients with Idiopathic Bilateral Atrial Dilatation

“…These findings suggest that increased wall stress and local stress evoke the expression of ANP and BNP genes within the left ventricles. Right atrial enlargement due to both long-term atrial fibrillation and, presumably, right ventricular diastolic dysfunction caused by aging could dilate the tricuspid valve annulus and cause tricuspid regurgitation [12]. In our patients with IBAD, we cannot categorically deny the presence of slight ventricular diastolic dysfunction caused by aging, as cardiac catheterization was not performed in all of these patients.…”