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

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.
  • Keranov, S.
  • Haen, S.
  • Vietheer, J.
  • Rutsatz, W.
  • Wolter, J. S.
  • Kriechbaum, S. D.
  • von Jeinsen, B.
  • Bauer, P.
  • Tello, K.
  • Richter, M.
  • Dörr, O.
  • Rieth, A. J.
  • Nef, H.
  • Hamm, C. W.
  • Liebetrau, C.
  • Rolf, A.
  • Keller, T.

Keywords

  • LV remodeling
  • Mri
  • RV remodeling
  • Rvef
  • T1 mapping
  • Tapse/pasp
Publication details
DOI: 10.3390/diagnostics11122188
Journal: Diagnostics (Basel)
Number: 12
Work Type: Original
Access number: 34943425
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