Key result
Right ventricular echo parameters linked to ~28% greater mortality risk in precapillary PH.
Why the study?
Echocardiographic prognostic indicators of mortality in precapillary pulmonary hypertension had been inconclusive.
Do right ventricular echocardiographic functional parameters predict mortality in patients with precapillary pulmonary hypertension?
Meta-Analysis (n=2,171)
Do right ventricular echocardiographic functional parameters predict mortality in patients with precapillary pulmonary hypertension?
Right ventricular echocardiographic parameters, specifically TAPSE, RVLS, RVFAC, RVEF, and RIMP, are significant prognostic indicators for mortality in patients with precapillary pulmonary hypertension.
Answers are grounded in this paper and cite their sources.
RV parameters should guide risk stratification in precapillary PH; confirms prognostic value across studies.
BACKGROUND: Echocardiographic prognostic indicators of precapillary pulmonary hypertension (PH) mortality has been inconclusive. This study aims to examine the prognostic values of right ventricular echocardiographic functional parameters in predicting precapillary PH mortality. METHODS: Systematic searches were conducted in the ScienceDirect, Medline, and Cochrane databases for longitudinal studies. Assessments included means and hazard ratios (HRs) for Tricuspid Annular Plane Systolic Excursion (TAPSE), Right Ventricular Systolic Pressure (RVSP), Right Ventricular Longitudinal Strain (RVLS), Right Ventricular Fractional Area Change (RVFAC), Right Ventricular Ejection Fraction (RVEF), and Right Ventricular Index of Myocardial Performance (RIMP). RESULTS: The meta-analysis included 24 cohort studies comprising 2171 participants. Mean values were as follows: TAPSE 17.62 mm, RVSP 77.50 mmHg, RVLS - 16.78%, RVFAC 29.81%, RVEF 37.56%, and RIMP 0.52. TAPSE (HR: 1.28; 95% CI 1.17-1.40; p < 0.001), RVLS (HR: 1.74; 95% CI 1.34-2.26; p < 0.001), RVFAC (HR: 1.40; 95% CI 1.13-1.75; p < 0.001), RVEF (HR: 1.08; 95% CI 1.02-1.15; p = 0.01), and RIMP (HR: 1.51; 95% CI 1.23-1.86; p < 0.001) emerged as significant prognosticators of precapillary PH mortality, with the exception of RVSP (HR: 1.04; 95% CI 0.99-1.09; p = 0.14). TAPSE summary receiver operating characteristics (sROC) analysis yielded an area under the curve (AUC) of 0.85 [95% CI 0.81-0.88] with a sensitivity of 0.81 [95% CI 0.63-0.91] and a specificity of 0.74 [95% CI 0.54-0.87]. RVLS sROC resulted in an AUC of 0.74 [95% CI 0.70-0.78] with a sensitivity of 0.74 [95% CI 0.57-0.86] and a specificity of 0.69 [95% CI 0.64-0.75]. CONCLUSIONS: TAPSE, RVLS, RVFAC, RVEF, and RIMP demonstrated promise as valuable prognostic indicators for precapillary PH mortality.
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Liyis et al. (2024) conducted a meta-analysis in Precapillary pulmonary hypertension (n=2,171). Right ventricular echocardiography functional parameters (e.g., TAPSE) was evaluated on Mortality (HR 1.28, 95% CI 1.17-1.40, p=<0.001). Right ventricular echocardiographic parameters, including TAPSE (HR 1.28) and RVLS (HR 1.74), were significant prognosticators of mortality in precapillary pulmonary hypertension.
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