IMR Press / RCM / Volume 25 / Issue 12 / DOI: 10.31083/j.rcm2512435
Open Access Review
Atrial Functional Tricuspid Regurgitation: A Comprehensive Review of Pathophysiology, Diagnosis, and Management Strategies
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Affiliation
1 Department of Medicine, BronxCare Health System, Bronx, NY 10457, USA
2 Department of Medicine, University of Medical Sciences and Technology (UMST), 12810 Khartoum, Sudan
3 Department of Medicine, Salaam Clinic, Cleveland, OH 44106, USA
4 Department of Radiology, Texas Medical Center Memorial Hermann Hospital, Houston, TX 77030, USA
5 American University of the Caribbean School of Medicine, Cupecoy, Sint Maarten
*Correspondence: moiudahmed@gmail.com (Moiud Mohyeldin)
These authors contributed equally.
Rev. Cardiovasc. Med. 2024, 25(12), 435; https://doi.org/10.31083/j.rcm2512435
Submitted: 22 May 2024 | Revised: 25 August 2024 | Accepted: 30 August 2024 | Published: 11 December 2024
Copyright: © 2024 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Atrial fibrillation (AF), the most prevalent sustained cardiac arrhythmia, is intricately linked with atrial functional tricuspid regurgitation (AFTR), a condition distinguished from ventricular functional tricuspid regurgitation by its unique pathophysiological mechanisms and clinical implications. This review article delves into the multifaceted aspects of AFTR, exploring its epidemiology, pathophysiology, diagnostic evaluation, and management strategies. Further, we elucidate the mechanisms underlying AFTR, including tricuspid annular dilatation, right atrial enlargement, and dysfunction, which collectively contribute to the development of tricuspid regurgitation in the absence of significant pulmonary hypertension or left-sided heart disease. The section on diagnostic evaluation highlights the pivotal role of echocardiography, supplemented by cardiac magnetic resonance (CMR) imaging and computed tomography (CT), in assessing disease severity and guiding treatment decisions. Management strategies for AFTR are explored, ranging from medical therapy and rhythm control to surgical and percutaneous interventions, underscoring the importance of a tailored, multidisciplinary approach. Furthermore, the article identifies gaps in current knowledge and proposes future research directions to enhance our understanding and management of AFTR. By providing a comprehensive overview of AFTR, this review aims to raise awareness among healthcare professionals and stimulate further research to improve patient care and outcomes in this increasingly recognized condition.

Keywords
atrial functional tricuspid regurgitation
atrial fibrillation
right atrial remodeling
tricuspid annular dilatation
leaflet tethering
right ventricular function
surgical tricuspid valve repair
transcatheter tricuspid valve interventions
tricuspid valve replacement
Funding
BronxCare Health System
Figures
Fig. 1.
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