Prognostic Value of the Right Ventricular-to-Left Ventricular Volume Ratio in Tricuspid Regurgitation

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Tricuspid regurgitation. Intervention: Right ventricular-to-left ventricular volume ratio ≥1.27 vs. Normal ratio (<1.27). Primary outcome: All-cause mortality (p=0.005).

Robert Zhang; Pablo Villar Calle; Rachel Axman; Zachary Falk; Mahniz Reza; Annie Tsay; Giorgia Falco; Andre Cheng; Shmuel Chen; Jonathan W. Weinsaft; Jiwon Kim

doi:10.1016/j.jacadv.2025.101922

July 3, 2025JACC AdvancesOpen Access

Prognostic Value of the Right Ventricular-to-Left Ventricular Volume Ratio in Tricuspid Regurgitation

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Key result

An abnormal right ventricular-to-left ventricular volume ratio was a strong predictor of all-cause mortality in patients with advanced tricuspid regurgitation.

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Graphical abstract published by JACC Advances — Graphical abstract · Published by JACC Advances · CC BY

Why the study?

TR is associated with RV remodeling, but conventional RV metrics may not fully reflect the interplay between the right and left ventricles.

Does the right ventricular-to-left ventricular volume ratio predict mortality in patients with advanced tricuspid regurgitation?

Key Points

Determine whether the right ventricular-to-left ventricular volume ratio provides prognostic information on mortality in patients with tricuspid regurgitation.
Assessed the right ventricular-to-left ventricular volume ratio as a dichotomous measure (normal: <1.27, abnormal: ≥1.27) and across severity strata.
Ascertained follow-up outcomes, including all-cause mortality, via electronic medical records and the Social Security Death Index.
An abnormal right ventricular-to-left ventricular volume ratio was significantly associated with all-cause mortality (P = 0.005).
The volume ratio effectively captured adverse biventricular remodeling linked to mortality in advanced tricuspid regurgitation that conventional right ventricular metrics failed to detect.

Study Design

Type

Cohort

Structured PICO

Does the right ventricular-to-left ventricular volume ratio predict mortality in patients with advanced tricuspid regurgitation?

P

Population

Patients with advanced tricuspid regurgitation (TR)

E

Exposure

Right ventricular-to-left ventricular volume ratio assessment

C

Comparator

Normal (<1.27) vs abnormal (≥1.27) ratio

O

Outcome

All-cause mortalityhard clinical

Main Result

p-value: p=0.005

The right ventricular-to-left ventricular volume ratio serves as a significant prognostic marker for mortality in patients with advanced tricuspid regurgitation.

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Implication

May inform prognosis in advanced tricuspid regurgitation; leaves open need for prospective validation before guiding decisions.

Abstract

BACKGROUND: Tricuspid regurgitation (TR) is associated with right ventricular (RV) remodeling; however, conventional RV metrics may not fully reflect the interplay between the right and left ventricles. OBJECTIVES: ) ratio in TR. METHODS: ratio was assessed as a dichotomous variable (normal: <1.27, abnormal: ≥1.27) and by severity strata. Follow-up data, including all-cause mortality, were collected using the Social Security Death Index and electronic medical records. RESULTS: ratio (P = 0.005). CONCLUSIONS: ratio is a strong predictor of mortality in advanced TR, capturing ventricular remodeling not identified by conventional metrics.

Discussion

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Cite This Study

Zhang et al. (2025) conducted a cohort in Tricuspid regurgitation. Right ventricular-to-left ventricular volume ratio ≥1.27 vs. Normal ratio (<1.27) was evaluated on All-cause mortality (p=0.005). An abnormal right ventricular-to-left ventricular volume ratio was a strong predictor of all-cause mortality in patients with advanced tricuspid regurgitation.

synapsesocial.com/papers/6aa3a0a8401b0278c3c97444 https://doi.org/10.1016/j.jacadv.2025.101922

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Prognostic Value of the Right Ventricular-to-Left Ventricular Volume Ratio in Tricuspid Regurgitation

Figures

Key Points

Study Design

Structured PICO

Main Result

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Prognostic Value of the Right Ventricular-to-Left Ventricular Volume Ratio in Tricuspid Regurgitation

Figures

Key Points

Study Design

Structured PICO

Main Result

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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