What question did this study set out to answer?

To identify echocardiographic parameters that can predict prognosis in low and intermediate risk PAH patients.

January 10, 2026Clinical Rheumatology0 citations

TAPSE/PASP combined with IVC can identify poor prognosis in PAH patients with low and intermediate risk

Q: What are the key findings of this study?

A TAPSE/PASP ratio <0.33 and IVC ≥16 mm predicts poor prognosis in low- and intermediate-risk PAH patients, with p < 0.001 for event-free survival.

Q: What does this research mean for the field?

A TAPSE/PASP ratio <0.33 and IVC ≥16 mm predicts poor prognosis in low- and intermediate-risk PAH patients, with p < 0.001 for event-free survival. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

WQWei QianUnion Hospital YZYue ZhangNanjing Medical University JDJiayi DaiNanjing Medical University

Key Result

A TAPSE/PASP ratio <0.33 and IVC ≥16 mm predicts poor prognosis in low- and intermediate-risk PAH patients, with p < 0.001 for event-free survival.

Key Points

To identify echocardiographic parameters that can predict prognosis in low and intermediate risk PAH patients.
Retrospective cohort study design
Inclusion of PAH patients categorized by WSPH criteria
Data collection through standardized case report forms
Statistical analysis using SPSS and R software
116 patients enrolled (57 low risk, 59 intermediate risk)
28 patients (24.1%) experienced clinical failure events during follow-up
TAPSE/PASP ratio < 0.33 and IVC ≥ 16 mm were independent predictors of poor prognosis
Kaplan-Meier analysis indicated significant differences in event-free survival based on these echocardiographic measures

Structured PICO

Does the combination of TAPSE/PASP < 0.33 and IVC ≥ 16 mm predict clinical failure events in low- and intermediate-risk PAH patients?

Population

116 patients with pulmonary arterial hypertension (PAH) classified as low risk (n=57) or intermediate risk (n=59) according to WSPH criteria. The key points specifically mention CTD-PAH (connective tissue disease-associated PAH).

Intervention

Echocardiographic assessment identifying the combination of TAPSE/PASP < 0.33 and IVC ≥ 16 mm

Comparator

Patients without the combination of TAPSE/PASP < 0.33 and IVC ≥ 16 mm

Outcome

Clinical failure events (event-free survival) at a median follow-up of 34.8 monthscomposite

The combination of TAPSE/PASP < 0.33 and IVC ≥ 16 mm provides a simple, non-invasive echocardiographic tool to identify poor prognosis and guide early treatment adjustment in low- and intermediate-risk PAH patients.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

OBJECTIVES: To identify echocardiographic parameters that predict prognosis in pulmonary arterial hypertension (PAH) patients with low and intermediate risk. METHODS: This single-center retrospective cohort study included PAH patients classified as low or intermediate risk according to WSPH criteria. All patients were regularly followed at the First Affiliated Hospital of Nanjing Medical University. Baseline and follow-up data were collected using standardized case report forms. Missing data were imputed using the random forest method. Statistical analyses were performed using SPSS 26.0 and R 4.3.1, with a two-sided p < 0.05 considered significant. RESULTS: A total of 116 PAH patients (57 low risk, 59 intermediate risk) were enrolled. During a median follow-up of 34.8 months, 28 patients (24.1%) experienced clinical failure events. The TAPSE/PASP ratio was an independent predictor of poor prognosis (HR = 0.002, 95% CI 1.09e-5-0.294, p = 0.015). Kaplan-Meier analysis showed that patients with TAPSE/PASP < 0.33 and IVC ≥ 16 mm had significantly worse event-free survival (p < 0.001). CONCLUSIONS: The combination of TAPSE/PASP < 0.33 and IVC ≥ 16 mm identifies poor prognosis among low- and intermediate-risk PAH patients, providing a simple echocardiographic tool for early risk stratification. Key Points • TAPSE/PASP ratio combined with IVC diameter provides a simple, non-invasive index to identify poor prognosis in low- and intermediate-risk CTD-PAH patients. • This combined echocardiographic assessment may facilitate early recognition of right ventricular-pulmonary arterial uncoupling and guide timely treatment adjustment. • It refines risk evaluation beyond conventional WSPH stratification, supporting individualized long-term management in CTD-PAH.

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