From the Guidelines
Squatting can temporarily reduce tricuspid regurgitation severity by increasing venous return to the right heart and raising systemic vascular resistance, but it is not a treatment for the underlying valve dysfunction. When a person squats, the increased intra-abdominal pressure and compression of lower extremity veins forces more blood back to the heart, increasing right ventricular preload. This preload increase helps improve right ventricular function and coaptation of the tricuspid valve leaflets, potentially reducing the regurgitant volume. Additionally, squatting increases afterload in the systemic circulation, which can indirectly affect right heart hemodynamics by altering left ventricular function and interventricular dependence. This maneuver is sometimes used during echocardiographic assessment to evaluate dynamic changes in tricuspid regurgitation, though its effects are transient and return to baseline once standing resumes. For patients with significant tricuspid regurgitation, squatting may provide temporary symptomatic relief in some cases, but definitive management typically requires medical therapy targeting the underlying cause or surgical/interventional valve repair or replacement in severe cases, as recommended by recent guidelines 1.
Key Points to Consider
- The effects of squatting on tricuspid regurgitation are temporary and not a substitute for definitive treatment.
- Definitive management of tricuspid regurgitation involves medical therapy, surgical, or interventional valve repair or replacement, especially in severe cases or when symptoms persist despite medical therapy 1.
- The decision for surgical intervention should consider the severity of tricuspid regurgitation, symptoms, and the presence of right ventricular dysfunction or other complicating factors, with valve repair being preferable to replacement when possible 1.
- Recent guidelines emphasize the importance of appropriate timing for intervention to prevent right ventricular dilatation and dysfunction, which can lead to worsening symptoms and increased mortality 1.
Clinical Implications
- Clinicians should be aware of the temporary effects of squatting on tricuspid regurgitation and use this maneuver as part of a comprehensive assessment rather than relying on it as a therapeutic intervention.
- Patients with significant tricuspid regurgitation should be evaluated for definitive treatment options, considering the severity of their condition, symptoms, and potential for intervention to improve quality of life and reduce morbidity and mortality.
From the Research
Effect of Squatting on Tricuspid Regurgitation (TR)
There are no research papers to assist in answering this question, as none of the provided studies discuss the effect of squatting on tricuspid regurgitation (TR) [ 2, 3, 4, 5, 6 ].
- The studies focus on the management, diagnosis, and treatment of TR, including surgical and transcatheter approaches [ 2, 3, 4, 5, 6 ].
- They discuss the pathophysiology, epidemiology, and clinical significance of TR, but do not mention the impact of squatting on the condition [ 2, 3, 4, 5, 6 ].
- Therefore, there is no available evidence to determine the effect of squatting on TR based on the provided studies [ 2, 3, 4, 5, 6 ].