scholarly journals Characteristics of idiopathic tricuspid regurgitation

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
LWY Li ◽  
MS Huang ◽  
WH Lee ◽  
WC Tsai

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Ministry of Science and Technology, Executive Yuan, Taiwan Background Tricuspid regurgitation (TR) were traditionally classified as primary and secondary TR. Recently a new category of TR was developed and named as idiopathic TR. However, diagnosis and characteristics of idiopathic TR were not consisted. We tried to identify idiopathic TR by a new systemic approach and studied its characteristics. Methods 207 consecutive patients (mean age 71.2 ± 14.7 years, 40.6% male) identified as significant TR (moderate and severe) by echocardiography were recruited. We classified TR by a new systemic approach. The classification process started from identified primary TR, then pacemaker related TR, left heart disease related TR, congenital heart related TR, right ventricular (RV) myopathy, pulmonary hypertension and, finally idiopathic TR step by step. Results There were 29 (14%) primary TR, 18 (8.7%) pacemaker related, 81 (39.1 %) left heart diseases, 6 (2.9%) congenital heart diseases, 3 (1.4%) RV myopathy, 27 (13%) pulmonary hypertension, and 43 (20.8%) idiopathic TR. Mean age of idiopathic TR was 72.9 ± 11.4 years and 39.5% was male which were not different from other groups. Atrial fibrillation was presented highest in patients with pacemaker related TR (77.8%) and left heart disease (55.6%), lowest in primary TR (24.1%) and pulmonary HT (25.9%), and modest in idiopathic TR (44.2%). Among the echocardiographic characteristics of right heart measurements, idiopathic TR had lowest TR maximal velocity (3.0 ± 0.3 m/s), pulmonary (41.2 ± 8.7 mmHg) and right atrium pressure (5.3 ± 0.3 mmHg; all p <0.001). Idiopathic TR had smallest RV wall thickness (4.5 ± 1.4 mm; p = 0.008), tricuspid annulus diameter (3.2 ± 0.7 cm; p = 0.001), and right atrial area (18.9 ± 8.4 cm2; p <0.001). RV function represented as tricuspid annulus velocity S’ (12.8 ± 3.3 cm/s; p = 0.011) and RV fractional area change FAC (42.6 ± 16.0 %; p <0.001) were best in idiopathic TR. RV dysfunction (FAC < 35%) was lowest (14%) in idiopathic TR. Conclusions Idiopathic TR had better RV function then other types of TR. Idiopathic TR can be regarded as a unique disease category in studying TR.

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
WC Tsai ◽  
WY Lee ◽  
MS Huang ◽  
WH Lee

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Ministry of Science and Technology, Excutive Yuan, Taiwan Background Tricuspid regurgitation (TR) is traditionally classified as primary or secondary TR. The effects of TR on right ventricular (RV) function were not consistent. We hypothesized that secondary TR is not a unique group, sophisticated sub-grouping can be useful for studying effects of TR on RV function. Methods 207 consecutive patients identified as significant TR (moderate and severe) by echocardiography were recruited. Standard measurements for right heart were done according to guideline. Lateral tricuspid annulus systolic tissue velocity (S’) and RV fractional area change (FAC) were used for RV function. We classified these patients into primary TR and 6 subgroups of secondary TR according to a new systemic approach. Results Mean age of subjects was 71.2 ± 14.7 years, and there were 84 (40.6%) male. There were 29 (14%) primary TR. Secondary TR was further classified into 6 groups included 18 (8.7%) pacemaker related, 81 (39.1 %) left heart diseases, 6 (2.9%) congenital heart diseases, 3 (1.4%) RV myopathy, 27 (13.0%) pulmonary hypertension, and 43 (20.8%) idiopathic TR. Among 4 major groups (congenital heart disease and RV myopathy were not included in analysis due to low numbers) of secondary TR, S’ was significant higher in idiopathic TR and RV FAC were higher in pacemaker related and idiopathic TR. RV dysfunction was defined as FAC < 35%. RV dysfunction presented mostly in pulmonary hypertension related TR and leastly in idiopathic TR (59.3% vs. 14%, p <0.001). Multivariate analysis using idiopathic TR as reference and controlled TR maximal velocity, RV end-diastolic area, right atrial area, and severity of TR, left heart disease related TR had higher risk of RV dysfunction (OR 4.178, 95% CI 1.490-11.703, p = 0.007). Conclusions Effects of TR on RV function were different among different subgroups of secondary TR. Left heart disease related TR had highest risk for RV dysfunction. Secondary TR should not be regarded as a single disease.


ESC CardioMed ◽  
2018 ◽  
pp. 2543-2547
Author(s):  
Jean-Luc Vachiery

Pulmonary hypertension is a common complication of left heart diseases. Although it may be encountered in all disorders, pulmonary hypertension in left heart disease is most common in heart failure with preserved or reduced ejection fraction. When present, pulmonary hypertension in left heart disease has been associated with more symptoms, exercise intolerance, and a negative impact on outcome.


2020 ◽  
Vol 92 (9) ◽  
pp. 54-62
Author(s):  
A. M. Aleevskaya ◽  
O. N. Vyborov ◽  
V. V. Gramovich ◽  
T. V. Martynyuk

Рulmonary hypertension (PH) is a common complication of left heart diseases. In addition to a passive increase of pressure in the venous bed of the pulmonary circulation, leading to an increase of mean pulmonary pressure, signs of precapillary PH could be detected in some patients. Since 2013, a hemodynamic subtype of PH due to left heart diseases combined post/precapillary PH has been identified, with a more unfavorable prognosis and high mortality.


2020 ◽  
Author(s):  
L. K. Pallos ◽  
J. M. Dietrich ◽  
A. Simon ◽  
E. Carls ◽  
M. Matthey ◽  
...  

2015 ◽  
Vol 14 (2) ◽  
pp. 105-110

Guest editor Teresa De Marco, MD, along with Brian Shapiro, MD, Mayo Clinic, Jacksonville, FL, convened a panel of experts to discuss the challenges in diagnosis and treatment and the emerging science regarding pulmonary hypertension due to left heart disease. Contributing to the engaging discussion were James Fang, MD, University of Utah School of Medicine; Barry Borlaug, MD, Mayo Clinic, Rochester, MN; and Srinivas Murali, MD, Allegheny Health Network, Pittsburgh, PA.


2018 ◽  
Vol 16 (6) ◽  
pp. 555-560 ◽  
Author(s):  
Ghazal Kabbach ◽  
Debabrata Mukherjee

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