Aims Atrial functional tricuspid regurgitation (A-FTR) is a recently defined phenotype of functional tricuspid regurgitation (FTR) associated with persistent/permanent atrial fibrillation. Differently from the classical ventricular form of FTR (V-FTR), patients with A-FTR might present with severely dilated right atrium and tricuspid annulus (TA), and with preserved right ventricular (RV) size and systolic function. However, the geometry and function of the right ventricle, right atrium, and TA in patients with A-FTR and V-FTR remain to be systematically evaluated. Accordingly, we sought to: (i) study the geometry and function of the right ventricle, right atrium, and TA in A-FTR by two- and three-dimensional transthoracic echocardiography; and (ii) compare them with those found in V-FTR. Methods and results We prospectively analysed 113 (44 men, age 68 ± 18 years) FTR patients (A-FTR = 55 and V-FTR = 58) that were compared to two groups of age- and sex-matched controls to develop the respective Z-scores. Severity of FTR was similar in A-FTR and V-FTR patients. Z-scores of RV size were significantly larger, and those of RV function were significantly lower in V-FTR than in A-FTR (P < 0.001 for all). The right atrium was significantly enlarged in both A-FTR and V-FTR compared to controls (P < 0.001, Z-scores > 2), with similar right atrial (RA) maximum volume (RAVmax) between A-FTR and V-FTR (P = 0.2). Whereas, the RA minimum volumes (RAVmin) were significantly larger in A-FTR than in V-FTR (P = 0.001). Conclusion Despite similar degrees of FTR and RAVmax size, A-FTR patients show larger RAVmin and smaller TA areas than V-FTR patients. Conversely, V-FTR patients show dilated, more elliptic and dysfunctional right ventricle than A-FTR patients.

中文翻译：

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功能性三尖瓣关闭不全心房和心室表型患者的右心室几何形状和功能

目的 心房功能性三尖瓣关闭不全 (A-FTR) 是最近定义的与持续性/永久性心房颤动相关的功能性三尖瓣关闭不全 (FTR) 表型。与经典心室形式的 FTR (V-FTR) 不同，A-FTR 患者可能出现右心房和三尖瓣环 (TA) 严重扩张，并保留右心室 (RV) 大小和收缩功能。然而，A-FTR 和 V-FTR 患者的右心室、右心房和 TA 的几何形状和功能仍有待系统评估。因此，我们试图： (i) 通过二维和三维经胸超声心动图研究 A-FTR 中右心室、右心房和 TA 的几何形状和功能；(ii) 将它们与 V-FTR 中发现的进行比较。方法和结果 我们前瞻性分析了 113 名（44 名男性，年龄 68 ± 18 岁）将 FTR 患者（A-FTR = 55 和 V-FTR = 58）与两组年龄和性别匹配的对照组进行比较，以得出各自的 Z 分数。A-FTR 和 V-FTR 患者的 FTR 严重程度相似。与 A-FTR 相比，V-FTR 中 RV 大小的 Z 分数显着更大，而 RV 功能的 Z 分数显着低于 A-FTR（所有 P < 0.001）。与对照组相比，A-FTR 和 V-FTR 的右心房均显着扩大（P < 0.001，Z 分数 > 2），A-FTR 和 V 之间的右心房 (RA) 最大容积 (RAVmax) 相似-FTR (P = 0.2)。然而，A-FTR 中的 RA 最小体积 (RAVmin) 显着大于 V-FTR (P = 0.001)。结论 尽管 FTR 和 RAVmax 大小的程度相似，但 A-FTR 患者比 V-FTR 患者显示出更大的 RAVmin 和更小的 TA 面积。反过来，