Academic Journal

Right Ventricle to Pulmonary Artery Coupling Predicts the Risk Stratification in Patients With Systemic Sclerosis-Associated Pulmonary Arterial Hypertension

التفاصيل البيبلوغرافية
العنوان: Right Ventricle to Pulmonary Artery Coupling Predicts the Risk Stratification in Patients With Systemic Sclerosis-Associated Pulmonary Arterial Hypertension
المؤلفون: Jinzhi Lai, Jiuliang Zhao, Kaiwen Li, Xiaohan Qin, Hui Wang, Zhuang Tian, Qian Wang, Mengtao Li, Xiaoxiao Guo, Yongtai Liu, Xiaofeng Zeng
المصدر: Frontiers in Cardiovascular Medicine, Vol 9 (2022)
بيانات النشر: Frontiers Media S.A., 2022.
سنة النشر: 2022
المجموعة: LCC:Diseases of the circulatory (Cardiovascular) system
مصطلحات موضوعية: pulmonary arterial hypertension, systemic sclerosis, right ventricle to pulmonary artery coupling, TAPSE/PASP, echocardiography, Diseases of the circulatory (Cardiovascular) system, RC666-701
الوصف: BackgroundPulmonary arterial hypertension (PAH) is a serious complication of systemic sclerosis (SSc). PAH has high mortality, and risk assessment is critical for proper management. Whether the right ventricle to pulmonary artery (RV-PA) coupling accurately assesses risk status and predicts prognosis in patients with SSc-associated PAH has not been investigated.MethodsBetween March 2010 and July 2018, 60 consecutive patients with SSc-associated PAH diagnosed by right heart catheterization were enrolled prospectively, and the mean follow-up period was 52.9 ± 27.0 months. The RV-PA coupling was assessed by the ratio of tricuspid annular plane systolic excursion (TAPSE) and pulmonary artery systolic pressure (PASP) which was obtained by transthoracic echocardiography. The simplified risk stratification strategy was applied to assess the risk level of participants, and the endpoint was a composite of all-cause death and clinical worsening.ResultsThe receiver operating characteristic (ROC) curve of the ability to determine high-risk patients identified the optimal cut-off value of the TAPSE/PASP ratio as 0.194 mm/mmHg, and the ratio appeared to be a reliable indicator in the stratification of patients with high risk (area under the curve = 0.878, ROC P-value = 0.003), which showed the highest positive likelihood ratio (LR) (5.4) and the lowest negative LR (0) among a series of echocardiographic parameters. The TAPSE/PASP ratio was an independent predictive factor (HR = 0.01, 95% CI: 0.00–0.77, P = 0.037) for the composite endpoint, and patients with a TAPSE/PASP ratio >0.194 had a better overall survival for both the composite endpoint (log-rank χ2 = 5.961, P = 0.015) and all-cause mortality (log-rank χ2 = 8.004, P = 0.005) compared to the patients with a TAPSE/PASP ≤ 0.194.ConclusionRV-PA coupling assessed by the TAPSE/PASP ratio provides added value as a straightforward and non-invasive approach for predicting risk stratification of patients with SSc-associated PAH. Meanwhile, a lower TAPSE/PASP ratio identified a subgroup with worse prognosis.
نوع الوثيقة: article
وصف الملف: electronic resource
اللغة: English
تدمد: 2297-055X
Relation: https://www.frontiersin.org/articles/10.3389/fcvm.2022.872795/full; https://doaj.org/toc/2297-055X
DOI: 10.3389/fcvm.2022.872795
URL الوصول: https://doaj.org/article/0d7df472801c4d8fae13912233c27754
رقم الانضمام: edsdoj.0d7df472801c4d8fae13912233c27754
قاعدة البيانات: Directory of Open Access Journals
الوصف
تدمد:2297055X
DOI:10.3389/fcvm.2022.872795