The TAPSE/PASP ratio demonstrated superior diagnostic accuracy for detecting right ventricular dysfunction (1-AUC 0.736) compared to TAPSE (1-AUC 0.648) and S' wave (1-AUC 0.587).
Observational (n=141)
Does the TAPSE/PASP ratio improve diagnostic accuracy for identifying right ventricular dysfunction compared to conventional echocardiographic parameters in patients with pulmonary hypertension?
The TAPSE/PASP ratio demonstrates superior diagnostic accuracy for detecting right ventricular dysfunction in pulmonary hypertension compared to individual conventional echocardiographic measures.
Effect estimate: 1-AUC 0.736
Abstract Introduction Pulmonary hypertension (PH) is a complex and progressive condition characterized by elevated pulmonary arterial pressure, which often leads to right ventricular (RV) dysfunction and poor clinical outcomes. Early and accurate assessment of RV function is essential for the management and prognostication of patients with PH. Among various echocardiographic markers, the ratio of tricuspid annular plane systolic excursion to pulmonary artery systolic pressure (TAPSE/PASP) has emerged as a promising non-invasive measure of RV–pulmonary arterial coupling. Purpose This study aimed to evaluate the diagnostic accuracy of the TAPSE/PASP ratio in identifying RV dysfunction and to compare its performance with other conventional echocardiographic parameters. Methods This was a retrospective study including patients diagnosed with PH, defined as a mean pulmonary artery pressure (mPAP) 20 mmHg on right heart catheterization (RHC), between August 2021 and May 2025. Demographic and echocardiographic data were collected. RV dysfunction was defined as a fractional area change (FAC) 35%. Results A total of 141 patients were included, of whom 67% were female, with a mean age of 60 ± 16 years. Table 1 summarizes echocardiographic and hemodynamic data. RV dysfunction was present in 52% of patients and was associated with significantly lower TAPSE (18 vs. 21 mm, p 0.001), lower lateral tricuspid annular systolic velocity (S’ wave) (10.9 vs. 11.8 cm/s, p = 0.038), higher right atrial (RA) end-systolic volume (74 vs. 51 mL, p 0.001), larger RA end-systolic area (22 vs. 19 cm², p = 0.009), elevated PASP (70 vs. 50 mmHg, p 0.001), and a lower TAPSE/PASP ratio (0.3 vs. 0.5, p 0.001).Regarding diagnostic accuracy, TAPSE/PASP showed a good diagnosis accuracy (1-AUC 0.736). Comparing to other parameters, this ratio showed higher accuracy than TPASE (1-AUC 0.648) or S’ wave (1-AUC 0.587). Regarding RA parameters, TPASE/PASP showed superior accuracy than RA volume (AUC 0.683) or RA area (AUC 0.687). Conclusion Our study suggest that TAPSE/PASP ratio demonstrated superior diagnostic accuracy for detecting RV dysfunction compared to individual echocardiographic measures such as TAPSE, S’ wave, RA volume, and RA area. These findings support the clinical utility of TAPSE/PASP as a reliable, non-invasive marker for assessing RV function in PH patients and underscore its potential role in routine echocardiographic evaluation.Table1
Viana et al. (Thu,) conducted a observational in Pulmonary hypertension (PH) (n=141). TAPSE/PASP ratio vs. Other conventional echocardiographic parameters (TAPSE, S' wave, RA volume, RA area) was evaluated on Diagnostic accuracy for identifying RV dysfunction (fractional area change <35%) (1-AUC 0.736). The TAPSE/PASP ratio demonstrated superior diagnostic accuracy for detecting right ventricular dysfunction (1-AUC 0.736) compared to TAPSE (1-AUC 0.648) and S' wave (1-AUC 0.587).