Potential use of sPAP /PAAT ratio in Severe Functional Tricuspid Regurgitation with Pulmonary Hypertension

Introduction To date, there is no specific evidence or criteria for the selection of patients with PH and severe tricuspid insufficiency that can be initiated into correction of tricuspid valvulopathy. Tricuspid regurgitation is a risk marker independent of mortality in patients with pulmonary hypertension. The critical factor for the success of the procedure is certainly to find the parameters to select patients so that they do not become just a futile act. Method From the initial group of 271 patients, were selected a final group of 123 patients, all diagnosed with precapillary PH confirmed by catheterization and with tricuspid regurgitation by echocardiography. Patients were in groups 1 and 2 according to the 2022 Pulmonary Hypertension Guidelines. Patients with right to left shunt were not excluded. Results In patients with severe precapillary PH the sPAP/PAAT ratio was close to 1 (0.89± 0.43), while in patients with mild precapillary PH or in the postcapillary group, the sPAP/PAAT ratio was considerably lower (0.47±0.20) p<0.001. The Average sPAP/PAAT of deceased patients was 0.76. 61.70% of deceased patients (42 out of 68) had severe tricuspid regurgitation. Conclusion In our study average sPAP/PAAT ratio of the deceased patients with severe FTR was 0.76 mmHg/ms, nevertheless, this knowledge could have a potential use but is not sufficient for full-informed qualification or disqualification for valve intervention which requires specific TTVR-related data