Right ventricle-pulmonary artery uncoupling parameters, specifically TAPSE/PASP ≤0.62 and TAS'/PASP ≤0.47, effectively differentiated HFpEF patients with pulmonary hypertension from those without.
Observational (n=113)
Do echocardiographic parameters of right ventricle-pulmonary artery uncoupling (TAPSE/PASP and TAS'/PASP) predict the presence of pulmonary hypertension in patients with HFpEF?
Echocardiographic parameters of right ventricle-pulmonary artery uncoupling (TAPSE/PASP and TAS'/PASP) are useful non-invasive markers to detect pulmonary hypertension in patients with HFpEF.
BACKGROUND: Pulmonary hypertension (PH) is highly prevalent in patients with heart failure with preserved ejection fraction (HFpEF), and it is a strong predictor of adverse outcomes. We aimed to determine possible echocardiographic parameters to predict the presence of PH in patients with HFpEF. METHODS AND RESULTS: A total of 113 patients with HFpEF were prospectively enrolled from November 2017 to July 2022. The patients underwent invasive cardiac catheterization and simultaneous echocardiography at rest and during exercise. The parameters indicating right ventricle-pulmonary artery uncoupling, including tricuspid annular plane systolic excursion (TAPSE)/pulmonary artery systolic pressure (PASP) and tricuspid annular systolic velocity (TAS')/PASP were calculated. Receiver operating characteristic curve analysis was used to determine the optimal cut-off points of TAPSE/PASP and TAS'/PASP to differentiate patients with HFpEF with PH from those without PH. Sixty-eight patients with HFpEF with PH and 45 without PH were included. Those with PH had lower TAPSE/PASP and TAS'/PASP at rest and during exercise compared with those without PH. Both resting/stress TAPSE/PASP and TAS'/PASP were correlated with rest/exercise pulmonary capillary wedge pressure and mean pulmonary artery pressure. In multivariable regression analysis, TAPSE/PASP remained a significant predictor of exercise pulmonary capillary wedge pressure and mean pulmonary artery pressure. In receiver operating characteristic curve analysis, the optimal cut-off points of TAPSE/PASP and TAS'/PASP to differentiate patients with HFpEF with PH from those without PH were ≤0.62 and ≤0.47, respectively. CONCLUSIONS: Right ventricle-pulmonary artery uncoupling is closely correlated with abnormal rest/exercise hemodynamics (pulmonary capillary wedge pressure and mean pulmonary artery pressure) in patients with HFpEF. TAPSE/PASP and TAS'/PASP can be useful parameters to detect PH in patients with HFpEF.
Chen et al. (Fri,) conducted a observational in Heart failure with preserved ejection fraction (HFpEF) (n=113). Right ventricle-pulmonary artery uncoupling (TAPSE/PASP and TAS'/PASP) vs. Patients without pulmonary hypertension was evaluated on Presence of pulmonary hypertension (PH). Right ventricle-pulmonary artery uncoupling parameters, specifically TAPSE/PASP ≤0.62 and TAS'/PASP ≤0.47, effectively differentiated HFpEF patients with pulmonary hypertension from those without.