{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T16:33:53Z","timestamp":1791650033104,"version":"4.3.4"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2020,5,5]],"date-time":"2020-05-05T00:00:00Z","timestamp":1588636800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Atrial fibrillation (AF) has been associated with tricuspid annulus (TA) dilation in patients with severe functional tricuspid regurgitation (TR); however, the impact of AF is less clear in patients without severe TR. Our aim was to characterize TA remodelling in patients with AF in the absence of severe TR using 3D transoesophageal echocardiography (TOE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Ninety patients underwent clinically indicated transthoracic and TOE: non-structural (NS)-AF (n\u2009=\u200930); AF with left heart disease (LHD) (n\u2009=\u200930), and controls in sinus rhythm (n\u2009=\u200930). Three-dimensional TOE datasets were analysed to measure TA dimensions using novel dedicated tricuspid valve software. The NS-AF group showed biatrial dilatation and normal right ventricular (RV) size with decreased longitudinal function compared to controls, whereas the LHD-AF group showed biatrial dilatation, RV enlargement, decreased biventricular function, and higher systolic pulmonary artery pressure compared with the other groups. Indexed TA area, minimum diameter, maximum diameter, and total perimeter were significantly larger in the NS-AF group than in controls (measurements in end-diastole: 6.4\u2009\u00b1\u20091.1 vs. 5.0\u2009\u00b1\u20090.6 cm2\/m2, 1.8\u2009\u00b1\u20090.3 vs. 1.6\u2009\u00b1\u20090.2\u2009cm\/m2, 2.1\u2009\u00b1\u20090.3 vs. 1.9\u2009\u00b1\u20090.2\u2009cm\/m2, and 6.6\u2009\u00b1\u20090.9 vs. 5.9\u2009\u00b1\u20090.7\u2009cm\/m2, respectively, all P\u2009&amp;lt;\u20090.05). There was no significant difference in any indexed TA parameter between AF groups. TA circularity index (ratio between minimum and maximal diameters) and TA fractional area change between end-diastole and end-systole were no different among the three groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>AF is associated with right atrial and tricuspid annular remodelling independent of the presence of LHD in patients with intrinsically normal tricuspid leaflets without severe TR.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjci\/jeaa058","type":"journal-article","created":{"date-parts":[[2020,3,11]],"date-time":"2020-03-11T08:34:00Z","timestamp":1583915640000},"page":"747-755","source":"Crossref","is-referenced-by-count":54,"title":["Understanding tricuspid valve remodelling in atrial fibrillation using three-dimensional echocardiography"],"prefix":"10.1093","volume":"21","author":[{"given":"Xochitl A","family":"Ortiz-Leon","sequence":"first","affiliation":[{"name":"Laboratory of Echocardiography, Cardiovascular Division, Yale New Haven Hospital, Yale School of Medicine, 20 York Street, New Haven, CT 06510, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edith L","family":"Posada-Martinez","sequence":"additional","affiliation":[{"name":"Laboratory of Echocardiography, Cardiovascular Division, Yale New Haven Hospital, Yale School of Medicine, 20 York Street, New Haven, CT 06510, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria C","family":"Trejo-Paredes","sequence":"additional","affiliation":[{"name":"Laboratory of Echocardiography, Cardiovascular Division, Yale New Haven Hospital, Yale School of Medicine, 20 York Street, New Haven, CT 06510, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan B","family":"Ivey-Miranda","sequence":"additional","affiliation":[{"name":"Laboratory of Echocardiography, Cardiovascular Division, Yale New Haven Hospital, Yale School of Medicine, 20 York Street, New Haven, CT 06510, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Pereira","sequence":"additional","affiliation":[{"name":"Laboratory of Echocardiography, Cardiovascular Division, Yale New Haven Hospital, Yale School of Medicine, 20 York Street, New Haven, CT 06510, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Crandall","sequence":"additional","affiliation":[{"name":"Laboratory of Echocardiography, Cardiovascular Division, Yale New Haven Hospital, Yale School of Medicine, 20 York Street, New Haven, CT 06510, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"DaSilva","sequence":"additional","affiliation":[{"name":"Laboratory of Echocardiography, Cardiovascular Division, Yale New Haven Hospital, Yale School of Medicine, 20 York Street, New Haven, CT 06510, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eileen","family":"Bouman","sequence":"additional","affiliation":[{"name":"Ultrasound Business Unit, Advanced Development, Siemens Healthineers, 685 Middlefield Road Mountain View, CA 94043, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyssa","family":"Brooks","sequence":"additional","affiliation":[{"name":"Laboratory of Echocardiography, Cardiovascular Division, Yale New Haven Hospital, Yale School of Medicine, 20 York Street, New Haven, CT 06510, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Gerardi","sequence":"additional","affiliation":[{"name":"Laboratory of Echocardiography, Cardiovascular Division, Yale New Haven Hospital, Yale School of Medicine, 20 York Street, New Haven, CT 06510, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ifeoma","family":"Ugonabo","sequence":"additional","affiliation":[{"name":"Laboratory of Echocardiography, Cardiovascular Division, Yale New Haven Hospital, Yale School of Medicine, 20 York Street, New Haven, CT 06510, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanwen","family":"Chen","sequence":"additional","affiliation":[{"name":"Laboratory of Echocardiography, Cardiovascular Division, Yale New Haven Hospital, Yale School of Medicine, 20 York Street, New Haven, CT 06510, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helene","family":"Houle","sequence":"additional","affiliation":[{"name":"Ultrasound Business Unit, Advanced Development, Siemens Healthineers, 685 Middlefield Road Mountain View, CA 94043, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph G","family":"Akar","sequence":"additional","affiliation":[{"name":"Laboratory of Echocardiography, Cardiovascular Division, Yale New Haven Hospital, Yale School of Medicine, 20 York Street, New Haven, CT 06510, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben A","family":"Lin","sequence":"additional","affiliation":[{"name":"Laboratory of Echocardiography, Cardiovascular Division, Yale New Haven Hospital, Yale School of Medicine, 20 York Street, New Haven, CT 06510, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert L","family":"McNamara","sequence":"additional","affiliation":[{"name":"Laboratory of Echocardiography, Cardiovascular Division, Yale New Haven Hospital, Yale School of Medicine, 20 York Street, New Haven, CT 06510, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernardo","family":"Lombo-Lievano","sequence":"additional","affiliation":[{"name":"Laboratory of Echocardiography, Cardiovascular Division, Yale New Haven Hospital, Yale School of Medicine, 20 York Street, New Haven, CT 06510, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose A","family":"Arias-Godinez","sequence":"additional","affiliation":[{"name":"Laboratory of Echocardiography, National Institute of Cardiology, Juan Badiano 1, Belisario Dom\u00ednguez Secc 16, Mexico City 14080, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lissa","family":"Sugeng","sequence":"additional","affiliation":[{"name":"Laboratory of Echocardiography, Cardiovascular Division, Yale New Haven Hospital, Yale School of Medicine, 20 York Street, New Haven, CT 06510, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,5,5]]},"reference":[{"key":"2020082810120845400_jeaa058-B1","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1016\/j.jcmg.2017.08.022","article-title":"3-Dimensional echocardiographic analysis of the tricuspid annulus provides new insights into tricuspid valve geometry and dynamics","volume":"12","author":"Addetia","year":"2019","journal-title":"JACC Cardiovasc Imaging"},{"key":"2020082810120845400_jeaa058-B2","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1007\/s10554-007-9210-3","article-title":"Assessment of normal tricuspid valve anatomy in adults by real-time three-dimensional echocardiography","volume":"23","author":"Anwar","year":"2007","journal-title":"Int J Cardiovasc Imaging"},{"key":"2020082810120845400_jeaa058-B3","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1053\/j.jvca.2012.12.014","article-title":"Tricuspid annular geometry: a three-dimensional transesophageal echocardiographic study","volume":"27","author":"Mahmood","year":"2013","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"2020082810120845400_jeaa058-B4","doi-asserted-by":"crossref","first-page":"599","DOI":"10.4103\/0971-9784.191569","article-title":"Tricuspid annulus: a spatial and temporal analysis","volume":"19","author":"Knio","year":"2016","journal-title":"Ann Card Anaesth"},{"key":"2020082810120845400_jeaa058-B5","doi-asserted-by":"crossref","first-page":"I492","DOI":"10.1161\/CIRCULATIONAHA.105.000257","article-title":"Three-dimensional geometry of the tricuspid annulus in healthy subjects and in patients with functional tricuspid regurgitation: a real-time, 3-dimensional echocardiographic study","volume":"114","author":"Fukuda","year":"2006","journal-title":"Circulation"},{"key":"2020082810120845400_jeaa058-B6","doi-asserted-by":"crossref","first-page":"e003241","DOI":"10.1161\/CIRCIMAGING.114.003241","article-title":"Comparison of 2-dimensional, 3-dimensional, and surgical measurements of the tricuspid annulus size: clinical implications","volume":"8","author":"Dreyfus","year":"2015","journal-title":"Circ Cardiovasc Imaging"},{"key":"2020082810120845400_jeaa058-B7","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1053\/j.jvca.2018.05.048","article-title":"Correlation of 2-dimensional and 3-dimensional echocardiographic analysis to surgical measurements of the tricuspid valve annular diameter","volume":"33","author":"Bhatt","year":"2019","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"2020082810120845400_jeaa058-B8","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1007\/s10554-006-9206-4","article-title":"Value of assessment of tricuspid annulus: real-time three-dimensional echocardiography and magnetic resonance imaging","volume":"23","author":"Anwar","year":"2007","journal-title":"Int J Cardiovasc Imaging"},{"key":"2020082810120845400_jeaa058-B9","doi-asserted-by":"crossref","first-page":"1190","DOI":"10.1016\/j.echo.2018.07.007","article-title":"Comparison between three-dimensional echocardiography and computed tomography for comprehensive tricuspid annulus and valve assessment in severe tricuspid regurgitation: implications for tricuspid regurgitation grading and transcatheter therapies","volume":"31","author":"Praz","year":"2018","journal-title":"J Am Soc Echocardiogr"},{"key":"2020082810120845400_jeaa058-B10","doi-asserted-by":"crossref","first-page":"2370","DOI":"10.1001\/jama.285.18.2370","article-title":"Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) study","volume":"285","author":"Go","year":"2001","journal-title":"JAMA"},{"key":"2020082810120845400_jeaa058-B11","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1111\/j.1540-8175.2011.01565.x","article-title":"Predictors for the development of severe tricuspid regurgitation with anatomically normal valve in patients with atrial fibrillation","volume":"29","author":"Najib","year":"2012","journal-title":"Echocardiography"},{"key":"2020082810120845400_jeaa058-B12","first-page":"315","article-title":"Severe tricuspid regurgitation in the aged: atrial remodeling associated with long-standing atrial fibrillation","volume":"48","author":"Yamasaki","year":"2006","journal-title":"J Cardiol"},{"key":"2020082810120845400_jeaa058-B13","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1016\/j.ijcard.2006.12.036","article-title":"Geometric and hemodynamic determinants of functional tricuspid regurgitation: a real-time three-dimensional echocardiography study","volume":"124","author":"Park","year":"2008","journal-title":"Int J Cardiol"},{"key":"2020082810120845400_jeaa058-B14","doi-asserted-by":"crossref","first-page":"e004897","DOI":"10.1161\/CIRCIMAGING.116.004897","article-title":"Functional tricuspid regurgitation caused by chronic atrial fibrillation: a real-time 3-dimensional transesophageal echocardiography study","volume":"10","author":"Utsunomiya","year":"2017","journal-title":"Circ Cardiovasc Imaging"},{"key":"2020082810120845400_jeaa058-B15","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1093\/ehjci\/jev014","article-title":"Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging","volume":"16","author":"Lang","year":"2015","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2020082810120845400_jeaa058-B16","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1093\/ejechocard\/jeq031","article-title":"European Association of Echocardiography recommendations for the assessment of valvular regurgitation. Part 2: mitral and tricuspid regurgitation (native valve disease)","volume":"11","author":"Lancellotti","year":"2010","journal-title":"Eur J Echocardiogr"},{"key":"2020082810120845400_jeaa058-B17","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1093\/ehjci\/jew335","article-title":"Recommendations on the echocardiographic assessment of aortic valve stenosis: a focused update from the European Association of Cardiovascular Imaging and the American Society of Echocardiography","volume":"18","author":"Baumgartner","year":"2017","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2020082810120845400_jeaa058-B18","doi-asserted-by":"crossref","first-page":"792","DOI":"10.1161\/01.CIR.82.3.792","article-title":"Atrial enlargement as a consequence of atrial fibrillation. A prospective echocardiographic study","volume":"82","author":"Sanfilippo","year":"1990","journal-title":"Circulation"},{"key":"2020082810120845400_jeaa058-B19","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.ijcard.2004.03.010","article-title":"Changes in left atrial size in patients with persistent atrial fibrillation: a prospective echocardiographic study with a 5-year follow-up period","volume":"101","author":"Wozakowska-Kaplon","year":"2005","journal-title":"Int J Cardiol"},{"key":"2020082810120845400_jeaa058-B20","first-page":"1256","article-title":"Cardioversion of atrial fibrillation and its effect on right ventricular function as assessed by tricuspid annular motion","volume-title":"Am J Cardiol","author":"Alam","year":"1999"},{"key":"2020082810120845400_jeaa058-B21","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.cardfail.2017.11.005","article-title":"Right heart dysfunction in heart failure with preserved ejection fraction: the impact of atrial fibrillation","volume":"24","author":"Gorter","year":"2018","journal-title":"J Card Fail"},{"key":"2020082810120845400_jeaa058-B22","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1016\/j.echo.2006.10.001","article-title":"Geometric changes of tricuspid valve tenting in tricuspid regurgitation secondary to pulmonary hypertension quantified by novel system with transthoracic real-time 3-dimensional echocardiography","volume":"20","author":"Sukmawan","year":"2007","journal-title":"J Am Soc Echocardiogr"},{"key":"2020082810120845400_jeaa058-B23","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1161\/CIRCULATIONAHA.106.611889","article-title":"Geometric determinants of functional tricuspid regurgitation: insights from 3-dimensional echocardiography","volume":"114","author":"Ton-Nu","year":"2006","journal-title":"Circulation"},{"key":"2020082810120845400_jeaa058-B24","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1093\/ehjci\/jet191","article-title":"Mechanisms of atrial mitral regurgitation: insights using 3D transoesophageal echo","volume":"15","author":"Ring","year":"2014","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2020082810120845400_jeaa058-B25","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.echo.2019.08.016","article-title":"Functional regurgitation of atrioventricular valves and atrial fibrillation: an elusive pathophysiological link deserving further attention","volume":"33","author":"Muraru","year":"2020","journal-title":"J Am Soc Echocardiogr"},{"key":"2020082810120845400_jeaa058-B26","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1016\/j.jcmg.2018.09.029","article-title":"Morphological assessment of the tricuspid apparatus and grading regurgitation severity in patients with functional tricuspid regurgitation: thinking outside the box","volume":"12","author":"Badano","year":"2019","journal-title":"JACC Cardiovasc Imaging"},{"key":"2020082810120845400_jeaa058-B27","doi-asserted-by":"crossref","first-page":"1474","DOI":"10.1016\/j.jacc.2011.06.032","article-title":"Evidence of atrial functional mitral regurgitation due to atrial fibrillation: reversal with arrhythmia control","volume":"58","author":"Gertz","year":"2011","journal-title":"J Am Coll Cardiol"}],"container-title":["European Heart Journal - Cardiovascular Imaging"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ehjcimaging\/article-pdf\/21\/7\/747\/33693212\/jeaa058.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ehjcimaging\/article-pdf\/21\/7\/747\/33693212\/jeaa058.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,8,31]],"date-time":"2020-08-31T12:50:21Z","timestamp":1598878221000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcimaging\/article\/21\/7\/747\/5830813"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,5]]},"references-count":27,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2020,5,5]]},"published-print":{"date-parts":[[2020,7,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjci\/jeaa058","relation":{},"ISSN":["2047-2404","2047-2412"],"issn-type":[{"value":"2047-2404","type":"print"},{"value":"2047-2412","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,7]]},"published":{"date-parts":[[2020,5,5]]}}}