Cladellas M, Garcia-Ribas C, Ble M, et al. - Given a poor prognosis post-aortic valve replacement (AVR) is seen in relation to severe pulmonary hypertension (PH) in patients with aortic stenosis, and the addition of two different echocardiographic signs to tricuspid regurgitation velocity (TRV) has been advised, by current European PH guidelines, for the estimation of PH, categorizing its probability as “low” (TRV ≤ 2.8m/s), “intermediate” (TRV 2.9-3.4m/s) and “high” (TRV > 3.4m/s), and given right ventricle (RV) signifies a crucial determinant of prognosis in PH, researchers performed this study with 429 consecutive patients (mean age 73 ± 8 years, 55% males) to examine the value of right atrial area> 18cm² and RV/left ventricle ratio > 1 in the long-term prognosis following AVR, essentially in the “intermediate” group. Patients were classified into “low” (n = 247), “intermediate” (n = 117) and “high” groups (n = 65). Further categorization of the “intermediate” group into 2 subgroups was done: “subgroup 2a” (n = 27, TRV non-measurable or ≤ 2.8m/s and two signs present) and “subgroup 2b” (n = 90, TRV 2.9-3.4m/s and none or only one sign present). The estimated overall mortality rates were 24%, 32% and 42% for the “low”, “intermediate” and “high”, respectively. Significantly higher mortality was reported in “subgroup 2a” vs “subgroup 2b”, both compared with the low group, following multivariate analysis. Experts concluded that better risk discrimination, specifically in the “intermediate” group, can be achieved by including right cavities measures to the PH probability model in the evaluation of long-term prognosis following AVR.