{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T13:02:27Z","timestamp":1792674147730,"version":"4.5.0"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>The determinants of tricuspid regurgitation (TR) hemodynamic severity remain to be established. We explored the hemodynamic correlates of right atrial (RA) pressure and stroke volume (SV) in patients with and without TR, and assessed the reliability of the indirect Fick method in relation to TR severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>\n                      In this observational study, right ventricular (RV) 3-dimensional echocardiography (3DE) was obtained simultaneously with direct Fick right heart catheterization. RVSV\n                      <jats:sub>3DE<\/jats:sub>\n                      and SV\n                      <jats:sub>RHC<\/jats:sub>\n                      were combined to determine the TR regurgitant fraction (RegFr=RVSV\n                      <jats:sub>3DE<\/jats:sub>\n                      -RVSV\n                      <jats:sub>RHC<\/jats:sub>\n                      \/RVSV\n                      <jats:sub>3DE<\/jats:sub>\n                      ). RA pressures and strain (or 3DE volumes) were combined to derive RA compliance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Out of 74 patients, 61% had moderate or severe TR. TR severity was associated with larger right heart chambers, lower RA compliance, higher values and lower inspiratory decrease of RA pressure, and lower cardiac index (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.01). In univariate analysis, RA V wave was associated with RegFr (\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      =\u22120.57) and with ln-transformed RA compliance\n                      <jats:sub>strain<\/jats:sub>\n                      (\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      =\u22120.74); SV index was associated with RegFr (\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      =\u22120.65). The effect of RegFr on V wave was mediated by ln-transformed RA compliance\n                      <jats:sub>strain<\/jats:sub>\n                      (\u03b2, 13.9 [95% CI, 7.6\u201320.2]). In multivariable analysis, RA V wave remained associated with 1\/RA compliance\n                      <jats:sub>strain<\/jats:sub>\n                      (\u03b2, 2.1 [95% CI, 1.4\u20132.7]), while SV index was associated with RegFr (\u03b2, \u221297.6 [95% CI, \u2212120.1 to \u221275.0]). The indirect Fick method overestimated cardiac index proportionally to RegFr (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>SV index is related to TR severity, while the effect of TR on RA V wave is mediated by RA compliance. Respiratory-related changes in RA hemodynamics are associated with TR severity. The indirect Fick method overestimates cardiac index proportionally to TR severity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circheartfailure.125.012813","type":"journal-article","created":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T05:00:17Z","timestamp":1751432417000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Determinants of Right Heart Hemodynamic Derangement in Patients With and Without Tricuspid Regurgitation"],"prefix":"10.1161","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3003-6499","authenticated-orcid":true,"given":"Sergio","family":"Caravita","sequence":"first","affiliation":[{"name":"Department of Management, Information and Production Engineering, University of Bergamo, Dalmine, Italy (S.C., E.L., C.B.)."},{"name":"Department of Cardiology, Ospedale San Luca IRCCS Istituto Auxologico Italiano, Milan, Italy (S.C., M.L., L.P.B., M.T., G.B.P., G.P., D.M., C.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Liberatore","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ospedale San Luca IRCCS Istituto Auxologico Italiano, Milan, Italy (S.C., M.L., L.P.B., M.T., G.B.P., G.P., D.M., C.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0379-3283","authenticated-orcid":true,"given":"Luigi P.","family":"Badano","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ospedale San Luca IRCCS Istituto Auxologico Italiano, Milan, Italy (S.C., M.L., L.P.B., M.T., G.B.P., G.P., D.M., C.B.)."},{"name":"Department of Medicine and Surgery, University of Milano-Bicocca, Italy (L.P.B., M.F.G., G.P., D.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6991-8516","authenticated-orcid":true,"given":"Maria Felicia","family":"Gagliardi","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, University of Milano-Bicocca, Italy (L.P.B., M.F.G., G.P., D.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8767-7581","authenticated-orcid":true,"given":"Leila","family":"De Lorenzo","sequence":"additional","affiliation":[{"name":"Universit\u00e0 Vita e Salute San Raffaele, Milan, Italy (L.D.L.)."},{"name":"Cardiology Unit, Heart Valve Center, IRCCS Ospedale San Raffaele, Milan, Italy (C.G., L.D.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4001-6934","authenticated-orcid":true,"given":"Antonio","family":"Sorropago","sequence":"additional","affiliation":[{"name":"Policlinico di Monza, Italy (A.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1319-0010","authenticated-orcid":true,"given":"Cosmo","family":"Godino","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Heart Valve Center, IRCCS Ospedale San Raffaele, Milan, Italy (C.G., L.D.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3004-2100","authenticated-orcid":true,"given":"Michele","family":"Tomaselli","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ospedale San Luca IRCCS Istituto Auxologico Italiano, Milan, Italy (S.C., M.L., L.P.B., M.T., G.B.P., G.P., D.M., C.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8816-9086","authenticated-orcid":true,"given":"Ettore","family":"Lanzarone","sequence":"additional","affiliation":[{"name":"Department of Management, Information and Production Engineering, University of Bergamo, 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