Diagnostics (Nov 2021)

Application and Validation of the Tricuspid Annular Plane Systolic Excursion/Systolic Pulmonary Artery Pressure Ratio in Patients with Ischemic and Non-Ischemic Cardiomyopathy

  • Stanislav Keranov,
  • Saskia Haen,
  • Julia Vietheer,
  • Wiebke Rutsatz,
  • Jan-Sebastian Wolter,
  • Steffen D. Kriechbaum,
  • Beatrice von Jeinsen,
  • Pascal Bauer,
  • Khodr Tello,
  • Manuel Richter,
  • Oliver Dörr,
  • Andreas J. Rieth,
  • Holger Nef,
  • Christian W. Hamm,
  • Christoph Liebetrau,
  • Andreas Rolf,
  • Till Keller

DOI
https://doi.org/10.3390/diagnostics11122188
Journal volume & issue
Vol. 11, no. 12
p. 2188

Abstract

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The main aim of this study was to assess the prognostic utility of TAPSE/PASP as an echocardiographic parameter of maladaptive RV remodeling in cardiomyopathy patients using cardiac magnetic resonance (CMR) imaging. Furthermore, we sought to compare TAPSE/PASP to TAPSE. The association of the echocardiographic parameters TAPSE/PASP and TAPSE with CMR parameters of RV and LV remodeling was evaluated in 111 patients with ischemic and non-ischemic cardiomyopathy and cut-off values for maladaptive RV remodeling were defined. In a second step, the prognostic value of TAPSE/PASP and its cut-off value were analyzed regarding mortality in a validation cohort consisting of 221 patients with ischemic and non-ischemic cardiomyopathy. A low TAPSE/PASP (<0.38 mm/mmHg) and TAPSE (<16 mm) were associated with a lower RVEF and a long-axis RV global longitudinal strain (GLS) as well as higher RVESVI, RVEDVI and NT-proBNP. A low TAPSE/PASP, but not TAPSE, was associated with a lower LVEF and long-axis LV GLS, and a higher LVESVI, LVEDVI and T1 relaxation time at the interventricular septum and the RV insertion points. Furthermore, in the validation cohort, low TAPSE/PASP was associated with a higher mortality and TAPSE/PASP was an independent predictor of mortality. TAPSE/PASP is a predictor of maladaptive RV and LV remodeling associated with poor outcomes in cardiomyopathy patients.

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