title: Impact of atrial fibrillation on tricuspid and mitral annular dilatation and valvular regurgitation.
abstract: To investigate the effects of atrial fibrillation (AF) on the mitral and tricuspid valves, the corresponding annular dilatation and valvular regurgitation were compared with 2-dimensional and Doppler echocardiography in 31 consecutive patients with lone AF and 28 normal controls. Mid-systolic mitral and tricuspid annular areas were measured from 2 diameters in 2 orthogonal apical echocardiograms. Percent (%) mitral regurgitant (MR) or tricuspid regurgitant (TR) jet area to the left or right atrial area was evaluated and % MR or TR jet area >20% was considered moderate or significant. Both the mitral and tricuspid annular areas in patients with lone AF were significantly larger compared with the controls (mitral: 9.5 +/- 1.2 vs 6.6 +/- 0.9 cm2, lone AF vs control, p < 0.01) (tricuspid: 12.0 +/- 2.0 vs 7.5 +/- 0.9 cm2, p < 0.01). The % increase in the annular area relative to the mean normal value was significantly greater in the tricuspid valve (44 +/- 18 vs 60 +/- 28%, p < 0.01). Moderate or severe MR was not observed and the incidence of moderate or severe valve regurgitation (% jet area >20%) was significantly higher in the tricuspid valve (0/31 vs 11/31, MR vs TR, p < 0.01) in patients with lone AF. The % TR jet area showed significant correlation with tricuspid annular area (r2 = 0.65, p < 0.001). Lone AF is associated with annular dilatation of both mitral and tricuspid valves, but the annular dilatation and valvular regurgitation are significantly greater in the tricuspid valve.
authors.affiliation: First Department of Internal Medicine, Kagoshima University School of Medicine, Japan.
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Zhou
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Otsuji
authors.forename: Shiro
authors.initials: S
authors.lastname: Yoshifuku
authors.forename: Toshinori
authors.initials: T
authors.lastname: Yuasa
authors.forename: Hui
authors.initials: H
authors.lastname: Zhang
authors.forename: Kunitsugu
authors.initials: K
authors.lastname: Takasaki
authors.forename: Keiko
authors.initials: K
authors.lastname: Matsukida
authors.forename: Akira
authors.initials: A
authors.lastname: Kisanuki
authors.forename: Shinichi
authors.initials: S
authors.lastname: Minagoe
authors.forename: Chuwa
authors.initials: C
authors.lastname: Tei
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications*; D016022:Case-Control Studies; D004106:Dilatation; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000503:physiopathology*; D008944:Mitral Valve Insufficiency / Q000209:etiology*; D015203:Reproducibility of Results; D014261:Tricuspid Valve / Q000503:physiopathology*