Prognostic role of TAPSE to PASP ratio in outpatients with left ventricular systolic dysfunction

被引:0
作者
Riccardi, Mauro [1 ]
Pagnesi, Matteo [1 ]
Corso, Rossana [2 ]
Sammartino, Antonio M. [1 ]
Tomasoni, Daniela [1 ]
Inciardi, Riccardo M. [1 ]
Lombardi, Carlo M. [1 ]
Adamo, Marianna [1 ]
Nodari, Savina [1 ]
Metra, Marco [1 ]
机构
[1] Univ Brescia, Inst Cardiol, Dept Med & Surg Specialties Radiol Sci & Publ Hlth, ASST Spedali Civili, Brescia, Italy
[2] ASST Sette Laghi, Dept Internal Med, Varese, Italy
来源
ESC HEART FAILURE | 2025年 / 12卷 / 02期
关键词
Heart failure; Outpatients; PASP; TAPSE; PRESERVED EJECTION FRACTION; CHRONIC HEART-FAILURE; CONTRACTILE FUNCTION; PRESSURE; MORBIDITY; MORTALITY;
D O I
10.1002/ehf2.15139
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aims Few data are available regarding the role of tricuspid annulus plane systolic excursion to pulmonary artery systolic pressure (TAPSE/PASP), a measurement of right ventricular to pulmonary artery coupling, in patients with chronic heart failure and left ventricular systolic dysfunction. Methods and results This retrospective single-centre study included outpatients with left ventricular systolic dysfunction (ejection fraction <= 50%) evaluated between January 2022 and December 2022. TAPSE/PASP was evaluated as a continuous variable and as tertiles according to its value on the first visit. The primary outcome of the study was a composite of all-cause mortality or heart failure (HF) events at the last available follow-up. Results A total of 642 patients were included (mean age 71 +/- 13 years, 78% male, mean left ventricular ejection fraction 40% [interquatile range 35-46]). Patients with lower TAPSE/PASP had more co-morbidities (i.e., atrial fibrillation, chronic kidney disease or previous cardiovascular implantable electronic device), an higher New York Heart Association class (P < 0.001), more signs of congestion (P = 0.007), and had more probability to receive intravenous furosemide during the visit (P < 0.001). After a median follow-up of 474 days [interquartile range 392-507 days], a total of 51 patients (8.0%) died (with 24 patients [3.8%] experiencing cardiovascular-related deaths), a total of 179 patients (28.1%) experienced a composite outcome, and 158 patients (24.8%) had HF events. Kaplan-Meier analysis showed that the estimated 1-year rate of the primary outcome was higher in the lowest tertile (38.0%), as compared with the intermediate (19.6%) and highest tertiles (14.9%; P-value log-rank <0.001). TAPSE/PASP ratio as a continuous variable was independently associated with the primary outcome (adjusted hazard ratio for 0.1 mm/mmHg increase 0.91, 95% CI 0.84-0.98, P = 0.009), predominantly driven by a higher risk of HF events during follow-up. Analysing the impact of TAPSE/PASP tertiles on the primary outcome, an independent associated was confirmed at multivariate analisys for the highest versus lowest tertile (adjusted hazard ratio 0.61, 95% CI 0.38-0.99, P = 0.044). Conclusions TAPSE/PASP was independently associated with mortality or HF events among ambulatory patients with left ventricular systolic dysfunction.
引用
收藏
页码:912 / 922
页数:11
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