A structured RVD scoring system has demonstrated strong prognostic value in individuals with advanced heart failure. Published in the International Journal of Cardiology, the study evaluated whether a five-point RVD score could enhance risk stratification beyond standard clinical and echocardiographic markers.

The cohort consisted of 201 patients undergoing right heart catheterisation and echocardiography. The RVD score incorporated pulmonary hypertension, reduced tricuspid annular plane systolic excursion, right ventricular enlargement, moderate or greater tricuspid regurgitation, and reduced inferior vena cava collapsibility. The primary endpoint was a composite of all-cause mortality or left ventricular assist device implantation.

Patients with higher scores (RVD 3–5) displayed more pronounced right ventricular remodelling, including greater diameter-to-length ratios and significantly elevated end-diastolic pressures. Clinical severity also increased across categories: compensated heart failure predominated in RVD0, whereas overt heart failure was common in RVD3–5. Over a 17-month median follow-up, 64 patients reached the endpoint, with event rates rising sharply from RVD0 to RVD1–2 and RVD3–5.

In multivariable analysis, the RVD score remained independently associated with adverse outcomes, outperforming individual echocardiographic predictors. These findings support its utility in identifying high-risk heart failure populations requiring closer surveillance and timely intervention.