Atrial secondary tricuspid regurgitation: pathophysiology, definition, diagnosis, and treatment

Atrial secondary tricuspid regurgitation (A-STR) is a newly recognized type of STR predominantly involving the dilation of the right atrium (RA) and tricuspid annulus (TA), whilst the systolic function of the left ventricle (LV) and right ventricle (RV) are preserved. Clinically relevant tricuspid regurgitation (TR) (greater or equal to moderate) has a prevalence of 0.55% in the general population,1 and A-STR accounts for approximately 10%–15% of clinically relevant TRs.2,3 Atrial secondary tricuspid regurgitation occurs most commonly in elderly women with long-standing atrial fibrillation (AF) and/or heart failure with preserved ejection fraction (HFpEF).4,5

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