The DOI matches its Crossref record; 25 of the 25 references it cites were found in a registry or an index.
Clinical Context and Mechanism of Functional Tricuspid Regurgitation in Patients With and Without Pulmonary Hypertension
Open accessAbstract
Background—: Functional tricuspid regurgitation (FTR) with structurally normal valve is of poorly defined mechanisms. Prevalence and clinical context of idiopathic FTR (Id-FTR) (without overt TR cause) are unknown. Methods and Results—: To investigate prevalence, clinical context, and mechanisms specific to FTR types, Id-FTR versus pulmonary hypertension-related (PHTN-FTR, systolic pulmonary pressure ≥50 mm Hg), we analyzed 1161 patients with prospectively quantified TR. Id-FTR (prevalence 12%) was associated with aging and atrial fibrillation. For mechanistic purposes, we measured valvular and right ventricular (RV) remodeling in 141 Id-FTR matched to 140 PHTN-FTR and to 99 controls with trivial TR for age, sex, atrial fibrillation, and ejection fraction. PHTN-FTR and Id-FTR were also matched for TR effective-regurgitant-orifice (ERO). Id-FTR valvular alterations (versus controls) were largest annular area (3.53±0.6 versus 2.74±0.4 cm 2 , P <0.0001) and lowest valvular/annular coverage ratio (1.06±0.1 versus 1.45±0.2, P <0.0001) but normal valve tenting height. PHTN-FTR had mild annular enlargement but excessive valve tenting height (0.8±0.3 versus 0.35±0.1 cm, P <0.0001). Valvular changes were linked to specific RV changes, largest basal dilatation, and normal length (RV conical deformation) in Id-FTR versus longest RV with elliptical/spherical deformation in PHTN-FTR. With increasing FTR severity (ERO ≥40 mm 2 ), changes specific to each FTR type were accentuated, and RV function (index of myocardial performance) was consistently reduced. Conclusions—: Id-FTR is frequent, linked to aging and atrial fibrillation, can be severe, and is of unique mechanism. In Id-FTR, excess annular and RV-basal enlargement exhausts valvular/annular coverage reserve, and RV conical deformation does not cause notable valvular tenting. Conversely, PHTN-FTR is determined by valvular tethering with tenting linked to RV elongation and elliptical/spherical deformation. These specific FTR-mechanisms may be important in considering surgical correction in FTR.
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Recommendations for chamber quantification☆
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Impact of tricuspid regurgitation on long-term survival
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Cited by
Otto, C. M., Nishimura, R. A., Bonow, R. O., Carabello, B. A., Erwin, J. P., Gentile, F., Jneid, H., Krieger, E. V., Mack, M., McLeod, C., et al. (2021) · Circulation · doi:10.1161/cir.0000000000000923 · Cited by 3,686
Burden of Tricuspid Regurgitation in Patients Diagnosed in the Community Setting
Topilsky, Y., Maltais, S., Medina Inojosa, J., Oguz, D., Michelena, H., Maalouf, J., Mahoney, D. W., & Enriquez-Sarano, M. (2019) · JACC: Cardiovascular Imaging · doi:10.1016/j.jcmg.2018.06.014 · Cited by 852
Self-citationBenfari, G., Antoine, C., Miller, W. L., Thapa, P., Topilsky, Y., Rossi, A., Michelena, H. I., Pislaru, S., & Enriquez-Sarano, M. (2019) · Circulation · doi:10.1161/circulationaha.118.038946 · Cited by 401
Self-citationJCS/JSCS/JATS/JSVS 2020 Guidelines on the Management of Valvular Heart Disease
Izumi, C., Eishi, K., Ashihara, K., Arita, T., Otsuji, Y., Kunihara, T., Komiya, T., Shibata, T., Seo, Y., Daimon, M., et al. (2020) · Circulation Journal · doi:10.1253/circj.cj-20-0135 · Cited by 367
2020 ACC/AHA guideline for the management of patients with valvular heart disease
Otto, C. M., Nishimura, R. A., Bonow, R. O., Carabello, B. A., Erwin, J. P., Gentile, F., Jneid, H., Krieger, E. V., Mack, M., McLeod, C., et al. (2021) · The Journal of Thoracic and Cardiovascular Surgery · doi:10.1016/j.jtcvs.2021.04.002 · Cited by 279
Metadata
- Authors
- Topilsky, Y., Khanna, A., Le Tourneau, T., Park, S., Michelena, H., Suri, R., Mahoney, D. W., & Enriquez-Sarano, M.
- Venue
- Circulation: Cardiovascular Imaging
- Published
- 2012-05
- Volume
- 5
- Issue
- 3
- Pages
- 314-323
- ISSN
- 1941-9651 (ISSN-L)
- 1942-0080
- OpenAlex
- W2548581114
- Cited by
- 299
- References
- 25
- FWCI
- 3.64
- Type
- journal article
- Language
- en
- Open access
- bronze
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- Topilsky, Y., Khanna, A., Le Tourneau, T., Park, S., Michelena, H., Suri, R., Mahoney, D. W., & Enriquez-Sarano, M. (2012). Clinical Context and Mechanism of Functional Tricuspid Regurgitation in Patients With and Without Pulmonary Hypertension. Circulation: Cardiovascular Imaging. https://doi.org/10.1161/circimaging.111.967919
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