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
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 accelerat...
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| Veröffentlicht in: | Circulation. Cardiovascular imaging 2019-09, Vol.12 (9), p.e009047 |
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| creator | Tello, Khodr Wan, Jun Dalmer, Antonia Vanderpool, Rebecca Ghofrani, Hossein A Naeije, Robert Roller, Fritz Mohajerani, Emad Seeger, Werner Herberg, Ulrike Sommer, Natascha Gall, Henning Richter, Manuel J |
| description | 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.
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.
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 |
| doi_str_mv | 10.1161/CIRCIMAGING.119.009047 |
| format | Article |
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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.
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 <0.31 mm/mm Hg had a significantly worse prognosis than those with higher TAPSE/PASP.
Echocardiographically determined TAPSE/PASP is a straightforward noninvasive measure of RV-arterial coupling and is affected by RV diastolic stiffness in severe pulmonary hypertension.
URL: https://www.clinicaltrials.gov. Unique identifier: NCT03403868.</description><identifier>ISSN: 1941-9651</identifier><identifier>EISSN: 1942-0080</identifier><identifier>DOI: 10.1161/CIRCIMAGING.119.009047</identifier><identifier>PMID: 31500448</identifier><language>eng</language><publisher>United States: Lippincott Williams & Wilkins</publisher><subject>Clinical Studies ; Echocardiography ; Heart Failure ; Imaging ; Original ; Pulmonary Hypertension</subject><ispartof>Circulation. Cardiovascular imaging, 2019-09, Vol.12 (9), p.e009047</ispartof><rights>2019 American Heart Association, Inc. 2019 American Heart Association, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c500t-9d23393f28dd8a829ce0263072c1695e3257eb28cdd1b4349d5aacd6d4f369cc3</citedby><cites>FETCH-LOGICAL-c500t-9d23393f28dd8a829ce0263072c1695e3257eb28cdd1b4349d5aacd6d4f369cc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,777,781,882,3674,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31500448$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tello, Khodr</creatorcontrib><creatorcontrib>Wan, Jun</creatorcontrib><creatorcontrib>Dalmer, Antonia</creatorcontrib><creatorcontrib>Vanderpool, Rebecca</creatorcontrib><creatorcontrib>Ghofrani, Hossein A</creatorcontrib><creatorcontrib>Naeije, Robert</creatorcontrib><creatorcontrib>Roller, Fritz</creatorcontrib><creatorcontrib>Mohajerani, Emad</creatorcontrib><creatorcontrib>Seeger, Werner</creatorcontrib><creatorcontrib>Herberg, Ulrike</creatorcontrib><creatorcontrib>Sommer, Natascha</creatorcontrib><creatorcontrib>Gall, Henning</creatorcontrib><creatorcontrib>Richter, Manuel J</creatorcontrib><title>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</title><title>Circulation. Cardiovascular imaging</title><addtitle>Circ Cardiovasc Imaging</addtitle><description>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.
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.
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 <0.31 mm/mm Hg had a significantly worse prognosis than those with higher TAPSE/PASP.
Echocardiographically determined TAPSE/PASP is a straightforward noninvasive measure of RV-arterial coupling and is affected by RV diastolic stiffness in severe pulmonary hypertension.
URL: https://www.clinicaltrials.gov. Unique identifier: NCT03403868.</description><subject>Clinical Studies</subject><subject>Echocardiography</subject><subject>Heart Failure</subject><subject>Imaging</subject><subject>Original</subject><subject>Pulmonary Hypertension</subject><issn>1941-9651</issn><issn>1942-0080</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNpVUd1O2zAYtaahwQqvgPwCof5J0vgGKYpYW4ltVYHeRq7ttEauHdkJom_Ho-G00LGrzz72-bEPANcY3WCc43E1X1bz3-V0_mcaAXaDEEPp5Bu4wCwlCUIF-n5Y44TlGT4HP0N4RiinKCt-gHOKM4TStLgAbytutOSddha6BnZbBR-9Fn1otYSltb3hHi4Mtwo-7EPnjBbw7lX0PkTG-AQterNzlvs9LH2n4lh4FULvFVwO2rBx_qBdhhDxnbLd4LbUm20HV3E3WEan5MDW3MDK9a3RdgO1hQ_qRUWlfx6zfaviRTtkuARnDTdBXX3MEXj6dfdYzZL7v9N5Vd4nIj61S5gklDLakELKgheECYVI_I4JEThnmaIkm6g1KYSUeJ3SlMmMcyFzmTY0Z0LQEbg96rb9eqekGEJzU7de72Kk2nFd_39i9bbeuJd6ghgrchIF8qOA8C4Er5oTF6N66LT-0mkEWH3sNBKvvzqfaJ8l0nce0KXI</recordid><startdate>20190901</startdate><enddate>20190901</enddate><creator>Tello, Khodr</creator><creator>Wan, Jun</creator><creator>Dalmer, Antonia</creator><creator>Vanderpool, Rebecca</creator><creator>Ghofrani, Hossein A</creator><creator>Naeije, Robert</creator><creator>Roller, Fritz</creator><creator>Mohajerani, Emad</creator><creator>Seeger, Werner</creator><creator>Herberg, Ulrike</creator><creator>Sommer, Natascha</creator><creator>Gall, Henning</creator><creator>Richter, Manuel J</creator><general>Lippincott Williams & Wilkins</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>5PM</scope></search><sort><creationdate>20190901</creationdate><title>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</title><author>Tello, Khodr ; Wan, Jun ; Dalmer, Antonia ; Vanderpool, Rebecca ; Ghofrani, Hossein A ; Naeije, Robert ; Roller, Fritz ; Mohajerani, Emad ; Seeger, Werner ; Herberg, Ulrike ; Sommer, Natascha ; Gall, Henning ; Richter, Manuel J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c500t-9d23393f28dd8a829ce0263072c1695e3257eb28cdd1b4349d5aacd6d4f369cc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Clinical Studies</topic><topic>Echocardiography</topic><topic>Heart Failure</topic><topic>Imaging</topic><topic>Original</topic><topic>Pulmonary Hypertension</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tello, Khodr</creatorcontrib><creatorcontrib>Wan, Jun</creatorcontrib><creatorcontrib>Dalmer, Antonia</creatorcontrib><creatorcontrib>Vanderpool, Rebecca</creatorcontrib><creatorcontrib>Ghofrani, Hossein A</creatorcontrib><creatorcontrib>Naeije, Robert</creatorcontrib><creatorcontrib>Roller, Fritz</creatorcontrib><creatorcontrib>Mohajerani, Emad</creatorcontrib><creatorcontrib>Seeger, Werner</creatorcontrib><creatorcontrib>Herberg, Ulrike</creatorcontrib><creatorcontrib>Sommer, Natascha</creatorcontrib><creatorcontrib>Gall, Henning</creatorcontrib><creatorcontrib>Richter, Manuel J</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Circulation. Cardiovascular imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tello, Khodr</au><au>Wan, Jun</au><au>Dalmer, Antonia</au><au>Vanderpool, Rebecca</au><au>Ghofrani, Hossein A</au><au>Naeije, Robert</au><au>Roller, Fritz</au><au>Mohajerani, Emad</au><au>Seeger, Werner</au><au>Herberg, Ulrike</au><au>Sommer, Natascha</au><au>Gall, Henning</au><au>Richter, Manuel J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>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</atitle><jtitle>Circulation. Cardiovascular imaging</jtitle><addtitle>Circ Cardiovasc Imaging</addtitle><date>2019-09-01</date><risdate>2019</risdate><volume>12</volume><issue>9</issue><spage>e009047</spage><pages>e009047-</pages><issn>1941-9651</issn><eissn>1942-0080</eissn><abstract>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.
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.
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 <0.31 mm/mm Hg had a significantly worse prognosis than those with higher TAPSE/PASP.
Echocardiographically determined TAPSE/PASP is a straightforward noninvasive measure of RV-arterial coupling and is affected by RV diastolic stiffness in severe pulmonary hypertension.
URL: https://www.clinicaltrials.gov. Unique identifier: NCT03403868.</abstract><cop>United States</cop><pub>Lippincott Williams & Wilkins</pub><pmid>31500448</pmid><doi>10.1161/CIRCIMAGING.119.009047</doi><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1941-9651 |
| ispartof | Circulation. Cardiovascular imaging, 2019-09, Vol.12 (9), p.e009047 |
| issn | 1941-9651 1942-0080 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7099862 |
| source | American Heart Association Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Clinical Studies Echocardiography Heart Failure Imaging Original Pulmonary Hypertension |
| title | 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 |
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