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Right atrial function, a mostly ignored but very valuable parameter in patients with secondary tricuspid regurgitation
  1. Michele Tomaselli1,
  2. Luigi P Badano1,2,
  3. Denisa Muraru1,2
  1. 1Department of Cardiology, Istituto Auxologico Italiano Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
  2. 2Department of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy
  1. Correspondence to Professor Luigi P Badano, Department of Medicine and Surgery, University of Milan-Bicocca, MIlano, Lombardia, Italy; luigi.badano{at}

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Significant secondary tricuspid regurgitation (STR) has increasing prevalence with age, it is associated with impaired quality of life, and it is an independent predictor of patients’ morbidity and mortality. Although the association of right ventricular (RV) function with outcome has been reported in patients with STR,1 2 the role of the right atrial (RA) geometry and function remains to be elucidated. In the past, RA has been considered as an innocent bystander that passively dilates due to the chronic volume overload imposed by STR. Recently, the role of RA enlargement in determining the dilation of the tricuspid annulus, as the main mechanism in the pathophysiology of atrial-STR, has been postulated.3 4 However, the association of RA function with outcomes in patients with STR received less attention.

, Galloo and co-authors5 reported that RA function (measured as RA longitudinal reservoir strain, RAsR) was independently associated with all-cause mortality at 10 years in a retrospective cohort analysis of 586 patients with severe STR and measurable RAsR . They derived the selected cohort from a large single-centre database of 1153 patients who underwent clinically indicated echocardiography and were found to have tricuspid regurgitation (TR), 788 of whom had severe TR. Among the 586 patients with severe STR and measurable RAsR, 521 were classified as ventricular STR and 65 as atrial STR. In the overall population, 10-year overall survival was 40% and was significantly lower in patients with a lower median …

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  • Contributors All authors have contributed to draft the editorial, have reviewed and approved the final text.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

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