Severe functional TR occurs with long-standing atrial fibrillation and causes right-sided heart failure. During long-term follow up, right atrial size progressively increased in association with worsening TR. Clinical features are characterized by severe functional TR due to annular dilation, markedly dilated right atrium, episodes of right-sided heart failure, absent or diminished fibrillation waves on electrocardiogram, bradycardia probably due to partial atrial standstill, and decreased atrial natriuretic peptide secretion. All had a long-standing history of atrial fibrillation (median duration, 23 years). The median age of patients with severe functional TR was 78 years. All patients had undergone clinical evaluation including echocardiography, electrocardiography and laboratory data. Eleven patients with severe functional TR were identified by reviewing the records of 16,235 consecutive patients. This study retrospectively analyzed patients with severe functional TR presenting with common clinical features suggesting a distinct syndrome. Severe idiopathic tricuspid regurgitation (TR) occurs in the aged, but the mechanism of TR is unclear and there is little information on atrial abnormalities associated with this condition. Yamasaki, Naohito Kondo, Fumiaki Kubo, Toru Okawa, Makoto Matsumura, Yoshihisa Kitaoka, Hiroaki Yabe, Toshikazu Furuno, Takashi Doi, Yoshinori Severe tricuspid regurgitation in the aged: atrial remodeling associated with long-standing atrial fibrillation. Read More " Atrial Fibrillation" Articles Atrial Fibrillation / Who Is at Risk for. Feature: Atrial Fibrillation Atrial Fibrillation: Diagnosis Past Issues / Winter 2015 Table of Contents. It would appear that clinically occult thyrotoxicosis can be identified consistently only with the thyrotropin-releasing hormone test and is the cause of idiopathic atrial fibrillation in a significant proportion of patients.« less Eight of the 10 patients had reversion to stable sinus rhythm after treatment with iodine-131 or carbimazole, either spontaneouslymore » or after direct current cardioversion. These 10 patients were predominantly male, had no clinical signs of thyrotoxicosis and a relative excess of nonpalpable autonomous thyroid nodules demonstrated with scintigraphy. A lack of response of serum thyrotropin to thyrotropin-releasing hormone, indicative of thyrotoxicosis, was found in 10 patients (13%), not all whom had raised serum thyroid hormone levels. Serum total thyroxine, triiodothyronine and thyrotropin response to thyrotropin-releasing hormone were measured in 75 consecutive patients presenting to a cardiology clinic with atrial fibrillation with no obvious cardiovascular cause. Occult thyrotoxicosis: a correctable cause of idiopathic atrial fibrillationĭOE Office of Scientific and Technical Information (OSTI.GOV)
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