Validation of the Tricuspid Annular Plane Systolic Excursion/Systolic Pulmonary Artery Pressure Ratio for the Assessment of Right Ventricular-Arterial Coupling in Severe Pulmonary Hypertension
单位：[1]Department of Internal Medicine,Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Germany[2]Department of Radiology,Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Germany[3]Department of Pulmonary and Critical Care Medicine, National Pulmonary Embolism & Pulmonary Vascular Diseases Research Group, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China[4]University of Arizona, Tucson[5]Department of Pneumology, Kerckhoff Heart, Rheuma and Thoracic Center, Bad Nauheim, Germany[6]Department of Medicine, Imperial College London, United Kingdom[7]Erasme University Hospital, Brussels, Belgium[8]Department of Pediatric Cardiology, University of Bonn, Germany
Background: The ratios of tricuspid annular plane systolic excursion (TAPSE)/echocardiographically measured systolic pulmonary artery pressure (PASP), fractional area change/invasively measured mean pulmonary artery pressure, right ventricular (RV) area change/end-systolic area, TAPSE/pulmonary artery acceleration time, and stroke volume/end-systolic area have been proposed as surrogates of RV-arterial coupling. The relationship of these surrogates with the gold standard measure of RV-arterial coupling (invasive pressure-volume loop-derived end-systolic/arterial elastance [Ees/Ea] ratio) and RV diastolic stiffness (end-diastolic elastance) in pulmonary hypertension remains incompletely understood. We evaluated the relationship of these surrogates with invasive pressure-volume loop-derived Ees/Ea and end-diastolic elastance in pulmonary hypertension. Methods: We performed right heart echocardiography and cardiac magnetic resonance imaging 1 day before invasive measurement of pulmonary hemodynamics and single-beat RV pressure-volume loops in 52 patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension. The relationships of the proposed surrogates with Ees/Ea and end-diastolic elastance were evaluated by Spearman correlation, multivariate logistic regression, and receiver operating characteristic analyses. Associations with prognosis were evaluated by Kaplan-Meier analysis. Results: TAPSE/PASP, fractional area change/mean pulmonary artery pressure, RV area change/end-systolic area, and stroke volume/end-systolic area but not TAPSE/pulmonary artery acceleration time were correlated with Ees/Ea and end-diastolic elastance. Of the surrogates, only TAPSE/PASP emerged as an independent predictor of Ees/Ea (multivariate odds ratio: 18.6; 95% CI, 0.8-96.1; P=0.08). In receiver operating characteristic analysis, a TAPSE/PASP cutoff of 0.31 mm/mm Hg (sensitivity: 87.5% and specificity: 75.9%) discriminated RV-arterial uncoupling (Ees/Ea <0.805). Patients with TAPSE/PASP Conclusions: Echocardiographically determined TAPSE/PASP is a straightforward noninvasive measure of RV-arterial coupling and is affected by RV diastolic stiffness in severe pulmonary hypertension.
基金：
Excellence Cluster Cardio-Pulmonary System (ECCPS)German Research Foundation (DFG); Collaborative Research Center (SFB) 1213-Pulmonary Hypertension and Cor Pulmonale, project B08 (German Research Foundation, Bonn, Germany) [SFB1213/1]
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外文
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中科院(CAS)分区：
出版当年[2018]版：
大类|1 区医学
小类|1 区核医学2 区心脏和心血管系统
最新[2025]版：
大类|1 区医学
小类|1 区核医学2 区心脏和心血管系统
JCR分区：
出版当年[2017]版：
Q1CARDIAC & CARDIOVASCULAR SYSTEMSQ1RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
最新[2023]版：
Q1CARDIAC & CARDIOVASCULAR SYSTEMSQ1RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
第一作者单位：[1]Department of Internal Medicine,Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Germany[*1]Department of Internal Medicine, Justus-Liebig-University Giessen, Klinikstrasse 32, 35392 Giessen, Germany
通讯作者：
通讯机构：[1]Department of Internal Medicine,Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Germany[*1]Department of Internal Medicine, Justus-Liebig-University Giessen, Klinikstrasse 32, 35392 Giessen, Germany
推荐引用方式(GB/T 7714)：
Tello Khodr,Wan Jun,Dalmer Antonia,et al.Validation of the Tricuspid Annular Plane Systolic Excursion/Systolic Pulmonary Artery Pressure Ratio for the Assessment of Right Ventricular-Arterial Coupling in Severe Pulmonary Hypertension[J].CIRCULATION-CARDIOVASCULAR IMAGING.2019,12(9):doi:10.1161/CIRCIMAGING.119.009047.
APA：
Tello, Khodr,Wan, Jun,Dalmer, Antonia,Vanderpool, Rebecca,Ghofrani, Hossein A....&Richter, Manuel J..(2019).Validation of the Tricuspid Annular Plane Systolic Excursion/Systolic Pulmonary Artery Pressure Ratio for the Assessment of Right Ventricular-Arterial Coupling in Severe Pulmonary Hypertension.CIRCULATION-CARDIOVASCULAR IMAGING,12,(9)
MLA：
Tello, Khodr,et al."Validation of the Tricuspid Annular Plane Systolic Excursion/Systolic Pulmonary Artery Pressure Ratio for the Assessment of Right Ventricular-Arterial Coupling in Severe Pulmonary Hypertension".CIRCULATION-CARDIOVASCULAR IMAGING 12..9(2019)
医学