The right ventricle systolic force ratio could predict the severity of the tricuspid regurgitation-RIVIERA ratio

Emrah A., Servet I., Ibrahim D., Fatih Y. M., Neryan O., Hande S., ...More

Journal of Clinical Ultrasound, vol.51, no.6, pp.963-971, 2023 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 51 Issue: 6
  • Publication Date: 2023
  • Doi Number: 10.1002/jcu.23457
  • Journal Name: Journal of Clinical Ultrasound
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Biotechnology Research Abstracts, CINAHL, EMBASE, MEDLINE
  • Page Numbers: pp.963-971
  • Keywords: acceleration, Doppler, force, right ventricle outflow tract, tricuspid regurgitation, velocity-time integral
  • Karadeniz Technical University Affiliated: Yes


Purpose: For assessing the severity of tricuspid regurgitation (TR), there is no gold standard. We developed a parameter, the right ventricular systolic force ratio—RIVIERA, using the continious wave Doppler analysis of TR and pulsed-wave analysis of the right ventricle outflow tract. We hypothesized that the RIVIERA would facilitate the ability to identify severe TR in clinical settings. Materials and Methods: We obtained data from routine transthoracic echocardiograms. All records reporting no or mild TR (n = 732), moderate TR (n = 584), and severe TR (n = 519) TR were reanalyzed to measure vena contracta (VC) width, TR jet area, effective regurgitant orifice (EROA) derived with the proximal isovelocity surface area method, the RIVIERA, and right-sided chamber volumes. Results: Significant linear trends were demonstrated for right atrial volume index, end-diastolic volume index, RVOT velocity time integral, TR jet area, TR-Vmax, TR-VTI, TR acceleration, VC width, EROA with increasing TR severity. Independent predictors of severe RT included RIVIERA <4.8, VC width ≥0.7 cm, TR jet area > 10 cm2, and EROA ≥0.4 cm2. Conclusion: The RIVIERA is a feasible, effective, and independent predictor of severe TR that enhances established techniques for estimating TR severity. For clinical decision-making and management, accurate measurement and classification of TR severity are essential. Therefore, it should be thought about include the RIVIERA in the integrative method to assessing TR severity.