{
  "abstract": "Background\n\nAtrial functional tricuspid regurgitation (AFTR) is increasingly recognized as a result of atrial remodelling in patients with atrial fibrillation (AF). However, prognostic predictors in this population remain incompletely defined.Objectives\n\nTo evaluate echocardiographic characteristics and identify predictors of all-cause mortality in patients with AFTR.Methods\n\nWe retrospectively studied consecutive patients with AF who underwent transthoracic echocardiography between 2017 and 2025. Inclusion required significant right atrial remodelling, defined as a right atrial area > 25 cm². Patients with at least moderate functional tricuspid regurgitation comprised the AFTR cohort, while patients with mild/trivial/no tricuspid regurgitation served as controls. Patients with primary valvular disease, cardiomyopathy, congenital heart disease, device-related valve disease, RV dilatation, or more than mild RV systolic dysfunction were excluded. Cox proportional hazards regression was performed to identify predictors of mortality.Results\n\nA total of 152 patients were included, comprising 120 patients with AFTR and 32 controls. Compared with controls, patients with AFTR demonstrated larger atrial dimensions, higher right-sided hemodynamic-burden, impaired RV longitudinal strain, and reduced reservoir RA strain. During a median follow-up of 6.3 years, 53 deaths (45%) occurred among patients with AFTR. In univariable Cox analysis, age (HR 1.02, 95% CI 1.00-1.04; p = 0.016), TR Vmax (HR 1.59, 95% CI 1.07-2.35; p = 0.020), and lower reservoir RA strain (HR 0.90, 95% CI 0.84-0.96; p = 0.003) were associated with mortality. In multivariable analysis, reservoir RA strain remained independently associated with mortality (adjusted HR 0.88, 95% CI 0.81-0.95; p < 0.001).Conclusion\n\nAFTR is characterized by marked biatrial remodelling and impaired right atrial function. Reduced RA reservoir strain was independently associated with mortality, supporting a potential role for RA deformation imaging in risk stratification in AFTR.",
  "abstract_shown": true,
  "affiliations": [
    "Heart Valve Clinic & Echocardiography Laboratory, Barts Heart Centre, St Bartholomew's Hospital, St Bartholomew's Hospital, West Smithfield, London, EC1A 7BE, UK.",
    "NIHR Barts Biomedical Research Centre, William Harvey Research Institute, Queen Mary University London, Charterhouse Square, London, EC1M 6BQ, UK.",
    "College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.",
    "King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia.",
    "Institute of Cardiovascular Sciences, UCL, London, UK.",
    "Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, West Smithfield, London, EC1A 7BE, UK.",
    "Cleveland Clinic London, London, UK.",
    "Heart Valve Clinic & Echocardiography Laboratory, Barts Heart Centre, St Bartholomew's Hospital, St Bartholomew's Hospital, West Smithfield, London, EC1A 7BE, UK. sanjeev.bhattacharyya@nhs.net.",
    "NIHR Barts Biomedical Research Centre, William Harvey Research Institute, Queen Mary University London, Charterhouse Square, London, EC1M 6BQ, UK. sanjeev.bhattacharyya@nhs.net.",
    "Institute of Cardiovascular Sciences, UCL, London, UK. sanjeev.bhattacharyya@nhs.net.",
    "Cleveland Clinic London, London, UK. sanjeev.bhattacharyya@nhs.net."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0,
        1,
        2,
        3
      ],
      "name": "Jawza Aldakhil"
    },
    {
      "affs": [
        4,
        5
      ],
      "name": "Kush Patel"
    },
    {
      "affs": [
        0
      ],
      "name": "Sveeta Badiani"
    },
    {
      "affs": [
        1,
        5
      ],
      "name": "Steffen E Petersen"
    },
    {
      "affs": [
        0,
        1,
        4,
        6
      ],
      "name": "Guy Lloyd"
    },
    {
      "affs": [
        7,
        8,
        9,
        10
      ],
      "name": "Sanjeev Bhattacharyya"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/5h01k0bn3emx4.bib",
  "cited_by": 0,
  "doi": "10.1186/s44156-026-00140-4",
  "fulltext_url": "https://europepmc.org/articles/PMC13679236",
  "id": "5h01k0bn3emx4",
  "issns": [
    "2055-0464"
  ],
  "landing_url": "https://europepmc.org/article/MED/42894198",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "RC666-701"
    ],
    [
      "openalex",
      "2705|Cardiac Valve Diseases and Treatments"
    ]
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  "openalex": "W7222883194",
  "pdf_url": "https://europepmc.org/articles/PMC13679236?pdf=render",
  "pmcid": "PMC13679236",
  "pmid": "42894198",
  "published": "2026-10-19",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/5h01k0bn3emx4.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:33Z",
      "native_id": "MED:42894198",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42894198"
    },
    {
      "first_seen": "2026-10-30T13:46:02Z",
      "native_id": "43c8223559c149ffaea4eee28d82c690",
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      "url": "https://doi.org/10.1186/s44156-026-00140-4"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2705|Cardiac Valve Diseases and Treatments",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Determinants of outcome in atrial functional tricuspid regurgitation.",
  "title_text": "Determinants of outcome in atrial functional tricuspid regurgitation.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:46:02Z",
  "url": "https://research.draconitic.com/paper/5h01k0bn3emx4",
  "venue": "Echo research and practice",
  "versions": []
}