Functional tricuspid regurgitation (TR) is common among patients with left heart disease and may recur during the follow-up period after selective tricuspid valve annuloplasty (TVA). This study aims to analyse the relationship between left atrial (LA) strain and the degree of preoperative functional TR and to explore the role of LA strain in predicting TR recurrence. This study included 63 patients with rheumatic mitral stenosis who underwent mitral valve replacement and concomitant TVA. Additionally, 20 healthy controls were enrolled. Preoperative conventional LA echocardiographic parameters and LA strain were measured. The association between LA strain and preoperative functional TR severity was analysed by Pearson correlation. Predictors of recurrent TR were determined by multivariate logistic regression analyses. Compared with the control group, the mitral stenosis group developed a significant impairment in terms of LA strain. The degree of preoperative functional TR exhibited moderate correlations with LA reservoir strain (r = − 0.57) and LA conduit strain (r = 0.48). During a median follow-up period of 66.4 ± 36.4 months, TR recurred in 18 patients. Preoperative LA reservoir strain and the mean transmitral gradient were predictors of postoperative TR recurrence. When the two indexes were combined to establish a prediction, the sensitivity and specificity of prediction increased. The area under the receiver operating characteristic curve of the combined indicator was higher than those of the single indicators (0.90 vs. 0.70 and 0.72). LA strain correlates with preoperative functional TR severity in patients with rheumatic mitral stenosis. The LA reservoir strain and preoperative mean transmitral gradient are independent predictive factors for recurrent TR after TVA.

中文翻译：

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左心房应变在瓣环成形术前后功能性三尖瓣关闭不全患者中的作用：长期随访研究

功能性三尖瓣反流 (TR) 在左心疾病患者中很常见，并且可能在选择性三尖瓣瓣环成形术 (TVA) 后的随访期间复发。本研究旨在分析左心房（LA）应变与术前功能性TR程度的关系，探讨LA应变在预测TR复发中的作用。该研究包括 63 名接受二尖瓣置换术和伴随 TVA 的风湿性二尖瓣狭窄患者。此外，还招募了 20 名健康对照。测量了术前常规 LA 超声心动图参数和 LA 应变。通过 Pearson 相关分析 LA 应变与术前功能性 TR 严重程度之间的关联。通过多变量逻辑回归分析确定复发性 TR 的预测因子。与对照组相比，二尖瓣狭窄组在 LA 应变方面出现了明显的损伤。术前功能性 TR 的程度与 LA 储层应变 (r = − 0.57) 和 LA 导管应变 (r = 0.48) 呈中等相关性。在 66.4 ± 36.4 个月的中位随访期间，18 名患者出现 TR 复发。术前 LA 储层应变和平均二尖瓣梯度是术后 TR 复发的预测因素。当两个指标结合起来建立预测时，预测的敏感性和特异性增加。组合指标的受试者工作特征曲线下面积高于单一指标（0.90 对 0.70 和 0.72）。LA 应变与风湿性二尖瓣狭窄患者术前功能性 TR 严重程度相关。