Key result
RV-PAuc linked to ~120% increased mortality in both cardiovascular and non-cardiovascular diseases.
Why the study?
The study sought to evaluate the prognostic value of the TAPSE/PASP ratio across cardiovascular and noncardiovascular diseases, identify RV-PAuc-related risk factors, and explore an optimal cutoff for risk stratification.
Does right ventricular-pulmonary arterial uncoupling (RV-PAuc) assessed by TAPSE/PASP ratio predict mortality in patients with cardiovascular and non-cardiovascular diseases?
Meta-Analysis (n=37,097)
Does right ventricular-pulmonary arterial uncoupling (RV-PAuc) assessed by TAPSE/PASP ratio predict mortality in patients with cardiovascular and non-cardiovascular diseases?
The echocardiographic TAPSE/PASP ratio is a strong prognostic marker for mortality across various diseases, with a proposed universal cutoff of ≤0.50 mm/mm Hg for risk stratification.
Answers are grounded in this paper and cite their sources.
Supports broader prognostic use of TAPSE/PASP ratio; leaves open whether it alters management in CV and non-CV conditions.
BACKGROUND: Right ventricular-pulmonary arterial uncoupling (RV-PAuc), assessed by the tricuspid annular plane systolic excursion-to-pulmonary artery systolic pressure (TAPSE/PASP) ratio, acts importantly to determine outcomes in both cardiovascular diseases (CVDs) and non-CVDs. OBJECTIVES: This study sought to evaluate the prognostic value of the TAPSE/PASP ratio across diseases, identify RV-PAuc-related risk factors, and explore an optimal cutoff for risk stratification and clinical application. METHODS: Two independent reviewers selected eligible studies, including 82 cohort studies with 32,482 patients for mortality endpoints and 17 observational studies with 4,615 participants for baseline TAPSE/PASP values for this meta-analysis (PROSPERO, CRD42024579107). Relative risk (RR) was calculated for mortality endpoints, and standard mean differences were used for comparisons. CONCLUSIONS: The TAPSE/PASP ratio is a potential prognostic marker for predicting mortality in CVDs and non-CVDs. Despite heterogeneity, a universal cutoff of ≤0.50 mm/mm Hg enhances its clinical applicability.
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Li et al. (2026) conducted a meta-analysis in Cardiovascular and non-cardiovascular diseases (n=37,097). Right ventricular-pulmonary arterial uncoupling (RV-PAuc) defined by TAPSE/PASP ratio was evaluated on Mortality (RR 2.20, 95% CI 2.02-2.40). Right ventricular-pulmonary arterial uncoupling (RV-PAuc) was positively associated with mortality in both cardiovascular and non-cardiovascular diseases (RR 2.20; 95% CI 2.02-2.40).
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