Lower TAPSE/SPAP ratios were associated with worse in-hospital outcomes but ejection fraction independently predicted outcomes with adjusted OR 0.91 (95% CI 0.86–0.96).
Observational (n=78)
No
Does the TAPSE/SPAP ratio predict in-hospital adverse outcomes in patients with acute decompensated heart failure?
While lower TAPSE/SPAP ratios are associated with worse in-hospital outcomes in acute decompensated heart failure, left ventricular ejection fraction remains the strongest independent predictor of adverse events.
Effect estimate: OR 0.91 per 1% increase in ejection fraction (95% CI 0.86–0.96) (95% CI 0.86–0.96)
p-value: p=0.0016
Abstract The ratio of tricuspid annular plane systolic excursion to systolic pulmonary artery pressure (TAPSE/SPAP) help us in determination the right ventricular function. This ratio has prognostic role in chronic heart failure, but its value in acute decompensation still uncertain. Our study evaluated the association between this ratio and short term in hospital adverse outcomes in patients with acute decompensated heart failure (ADHF). We performed a retrospective observational analysis including 78 ADHF patients. Clinical, laboratory, and echocardiographic variables were obtained on admission. The primary composite outcome included in hospital death, intravenous inotrope use, or admission to the cardiac intensive care unit. We applied ROC analysis and logistic regression models to assess the prognostic performance of TAPSE/SPAP. The composite outcome occurred in 44.9% of the study population. Patients who developed adverse events present with lower systolic blood pressure, ejection fraction, and TAPSE/SPAP ratio. The TAPSE/SPAP ratio demonstrated modest discrimination (AUC 0.613). In multivariable analysis, ejection fraction remained the only independent predictor of the composite outcome. Lower TAPSE/SPAP values were associated with unfavorable in hospital outcomes; however, its independent prognostic value was limited when adjusted for other variables.
Alhasan et al. (Thu,) conducted a observational in Adults hospitalized with acute decompensated heart failure, mean age 64.3 years, 37.2% female, 75.6% NYHA class IV (n=78). TAPSE/SPAP ratio measurement vs. No measurement or higher TAPSE/SPAP ratio was evaluated on Composite of in-hospital death, intravenous inotrope use, or admission to cardiac intensive care unit (OR 0.91 per 1% increase in ejection fraction (95% CI 0.86–0.96), 95% CI 0.86–0.96, p=0.0016). Lower TAPSE/SPAP ratios were associated with worse in-hospital outcomes but ejection fraction independently predicted outcomes with adjusted OR 0.91 (95% CI 0.86–0.96).