The following is a summary of “Incidence and Burden of Tricuspid Regurgitation in Patients With Atrial Fibrillation,” published in the December 2022 issue of Cardiology by Patlolla, et al.


In the absence of any known etiologies, atrial fibrillation (AF) is regarded as a risk factor for isolated tricuspid valve regurgitation (TR). For a study, researchers sought to determine the prevalence of clinically significant isolated TR and its effects in AF patients.

Adult patients who had recently developed AF were located using a population-based record-linking method. Patients with left-sided valve disease, pulmonary hypertension, prior cardiac surgery, moderate or more severe tricuspid valve disease, and reduced baseline left ventricular systolic/diastolic performance were also disqualified. The survival of the remaining patients (n = 691) was monitored throughout time to detect the emergence of moderate or higher TR and evaluate its impact.

A total of 232 individuals (33.6%) experienced TR that was moderate or worse. Among them, 73 patients (10.6%) had isolated TR without severe underlying structural heart disease. The incidence rate of any moderate or more severe TR was 3.9 instances, whereas the incidence rate of isolated TR was 1.3 cases per 100 person-years. The chance of developing TR was shown to be higher in those with permanent/persistent AF and female sex, whereas the risk was decreased in those with rhythm control. The development of any moderate or more significant TR (HR: 2.92; 95% CI: 2.29-3.73; P< 0.001) and isolated substantial TR (HR: 1.51; 95% CI: 1.03-2.22; P = 0.03) were linked to an elevated risk of eventual death throughout a median clinical follow-up of 13.3 years (IQR: 10.0-15.9 years).

Nearly a third of the individuals in the population-based cohort with AF over time experienced moderate to severe TR. A poorer prognosis for survival in AF patients was predicted by incident substantial TR, and incident isolated significant TR.

Reference: jacc.org/doi/10.1016/j.jacc.2022.09.045