BACKGROUND: Despite increasing clinical recognition of atrial functional tricuspid regurgitation (AF-TR), there remains limited literature regarding the characteristics, outcomes, and adverse prognosticators for this valve lesion. OBJECTIVES: This study aimed to elucidate clinical and echocardiographic characteristics and outcomes and to develop a novel risk model in a large cohort of patients with significant AF-TR. METHODS: Consecutive patients with at least moderate-to-severe AF-TR seen between January 2004 and December 2018 were retrospectively studied. Univariable and multivariable logistic regression (OR) were conducted to determine the risk factors and develop novel risk scores for 1-year all-cause mortality. RESULTS: Among 370 patients with AF-TR (mean age 73.9 ± 15.0 years, 82.2% female
mean follow-up 4.1 ± 3.6 years), 1-year and total mortality occurred in 81 (21.9%) and 219 (59.2%) of patients respectively, with a median survival of 2.5 and 8.5 years for patients with AF-TR effective regurgitant orifice area ≥0.40 and <
0.40 cm CONCLUSIONS: Patients with AF-TR had poor prognosis especially if tricuspid regurgitation effective regurgitant orifice area was ≥0.40 cm