Details

Autor(en) / Beteiligte

• Tello, Khodr
• Axmann, Jens
• Ghofrani, Hossein A.
• Naeije, Robert
• Narcin, Newroz
• Rieth, Andreas
• Seeger, Werner
• Gall, Henning
• Richter, Manuel J.

Titel

Relevance of the TAPSE/PASP ratio in pulmonary arterial hypertension

Ist Teil von

• International journal of cardiology, 2018-09, Vol.266, p.229-235

Ort / Verlag

Netherlands: Elsevier B.V

Erscheinungsjahr

2018

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• The ratio of echocardiography-derived tricuspid annular plane systolic excursion (TAPSE) and pulmonary arterial systolic pressure (PASP) has recently been reported as an independent prognostic parameter in heart failure. The TAPSE/PASP ratio has not been evaluated in detail in patients with pulmonary arterial hypertension (PAH). We analyzed TAPSE/PASP in 290 patients with PAH entered into the Giessen Pulmonary Hypertension Registry between November 2003 and July 2014. The prognostic relevance of TAPSE/PASP was assessed with multivariate Cox regression models, adjusting for clinical covariates, echocardiographic parameters, or hemodynamics, and was confirmed by Kaplan–Meier analyses. When stratified by tertile of TAPSE/PASP (low: <0.19 mm/mmHg; middle: 0.19–0.32 mm/mmHg; high: >0.32 mm/mmHg), patients in the low tertile showed significantly compromised hemodynamic, functional, and echocardiographic status compared with patients in the middle and high tertiles. In all multivariate models, TAPSE/PASP remained independently associated with overall mortality: the hazard ratio (95% confidence interval) was 1.87 (1.35–2.59) when adjusting for clinical covariates (p < .001), 5.21 (2.17–12.5) when adjusting for echocardiographic parameters (p < .001), 1.92 (1.30–2.83) when adjusting for hemodynamics (p = .001), and 4.13 (2.02–8.48) when adjusting for a selection of previously identified independent echocardiographic and hemodynamic prognostic indicators (p < .001). Kaplan–Meier analyses showed better overall survival in the middle and high tertiles versus the low tertile (log-rank p < .001). The TAPSE/PASP ratio is a meaningful prognostic parameter in patients with PAH and is associated with hemodynamics and functional class. •The TAPSE/PASP ratio is an important and meaningful prognostic parameter in pulmonary arterial hypertension.•TAPSE/PASP is significantly associated with pulmonary hemodynamics.•TAPSE/PASP values decrease as WHO functional class increases in patients with pulmonary arterial hypertension.