Valvular & structural heart diseaseDiagnostic or prognostic study
Redefining Right Ventricular Function
- Cohort study with external validation
- derivation cohort
- 2 independent external validation cohorts
Authors' conclusion
eRVEF independently predicts mortality in TR and provides incremental prognostic value over conventional prognostic markers.
Study context
- Population
- Consecutive patients with at least moderate functional tricuspid regurgitation (TR) (regurgitant fraction ≥30% or volume ≥30 mL) on cardiac magnetic resonance (CMR)derivation
- Participants
- 453 patients
- Comparison
- Impaired vs preserved effective right ventricular ejection fraction (RVEF)
- Outcome
- All-cause mortality
- Follow-up
- Median 2.7 years
Performance
As reported in the abstract
median 2.7 years (Q1-Q3: 0.6-6.6 years)
Each group vs preserved eRVEFHazard ratio (95% CI)P value
Impaired eRVEF
1.72(1.16–2.54)
P = 0.007eRVEFadjusted for age, RV size, TR severity, conventional RVEF, right-sided congestion
0.49(0.24–0.97)
P = 0.042- Overall mortality
- 20%
Further findings
All-cause mortality, adjusted for known TR risk markers (age, RV size, TR severity, conventional RVEF, right-sided congestion)
- Effective right ventricular ejection fraction (eRVEF) remained independently predictive of mortality
- HR: 0.49 [95% CI: 0.24-0.97]; P = 0.042
All-cause mortality, external validation in 2 independent cohorts (n = 316)
- eRVEF ≤25% prognostic in both cohorts
- HR: 2.66-2.86; both P < 0.05
Incremental mortality prediction (model chi-square)
- Adding eRVEF to a model with RVEF improved prediction
- chi-square from 30.6 to 37.0; P = 0.011
- Adding RVEF to eRVEF did not improve prediction
- chi-square from 35.4 to 37.0; P = 0.199
Original publication
Redefining Right Ventricular Function. JACC Cardiovasc Imaging. Published 16 April 2026. doi:10.1016/j.jcmg.2026.02.018
Summarised from the published abstract; every number is checked against it