2D‐Echocardiographic Estimation of Right Ventricular Volumes Using a Previously Validated Geometric Model Is Associated With Outcomes After Transcatheter Tricuspid Interventions

Aims To determine whether a simplified, previously proposed two‐dimensional (2D) approach to RV volume assessment can provide adjunctive prognostic information in patients undergoing Transcatheter Tricuspid Valve Interventions (TTVI). Methods and Results In this prospective single‐center study, 113 patients undergoing TTVI were included (T‐TEER; n = 91, heterotopic caval valve implantation; n = 17, and orthotopic transcatheter tricuspid valve replacement; n = 5). RV end‐diastolic and end‐systolic volumes were calculated using a previously described 2D‐based geometric model. The primary endpoint was a composite of all‐cause mortality or rehospitalization for acute decompensated heart failure at 1 year. The primary endpoint occurred in 47 patients (41.6%). In univariable Cox regression analysis, both RVEDVi (HR 1.05 per 10 mL/m 2 , 95% CI 1.01–1.10, p = 0.03) and RVESVi (HR 1.13 per 10 mL/m 2 , 95% CI 1.01–1.25, p = 0.03) were associated with adverse outcome. Receiver operating characteristic analysis identified cut‐off values of 90 mL/m 2 for RVEDVi and 35 mL/m 2 for RVESVi. Patients above these thresholds (diastolic, systolic, or both) showed significantly reduced event‐free survival (log‐rank p < 0.01). In a multivariable Cox regression analysis, RV dilatation showed a trend toward worse outcomes (HR 2.09, 95% CI 0.91–4.80, p = 0.08), whereas the TriScore remained independently associated with outcome (HR 1.30, 95% CI 1.10–1.53, p < 0.01). Conclusion RV volumes derived from a simple 2D echocardiographic model are associated with clinical outcomes and may provide additional information for the assessment of patients undergoing TTVI.