The role of the TAPSE/sPAP ratio as a predictor of mortality in Pulmonary Arterial Hypertension: Its value for patient risk stratification

• Published in: JHLT open 2025-02, Vol.7, p.100168, Article 100168
• Main Authors: Palacios-Moguel, Paul, Cueto-Robledo, Guillermo, González-Pacheco, Héctor, Ortega-Hernández, Jorge, Torres-Rojas, María Berenice, Navarro-Vergara, Dulce Iliana, García-Cesar, Marisol, González-Nájera, Cinthia Alejandra, Narváez-Oríani, Carlos Alfredo, Sandoval, Julio
• Format: Article
• Language: English
• Subjects: Pulmonary arterial hypertension; Right ventricular failure; Risk stratification; TAPSE/sPAP ratio; Ventriculo-arterial coupling
• ISSN: 2950-1334; 2950-1334
• DOI: 10.1016/j.jhlto.2024.100168

The tricuspid annular plane systolic excursion and systolic pulmonary artery pressure (TAPSE/sPAP) ratio has been proposed as an indicator of ventriculo-arterial coupling, predicting right ventricular failure (RVF) and mortality in patients with pulmonary arterial hypertension (PAH). To evaluate the usefulness of the TAPSE/sPAP ratio in predicting outcomes and improving risk stratification in patients with PAH. 156 patients with PAH were included. Clinical, functional, echocardiographic, and haemodynamic variables, along with the TAPSE/sPAP ratio, were analysed based on etiological PAH subgroups and outcomes. Additional statistical measures, such as the area under the curve (AUC), net reclassification index (NRI), and integrated discrimination improvement, assessed the predictive ability of TAPSE/sPAP in combination with the ESC/ERS risk score, and other risk assessment strategies (COMPERA and Reveal Lite 2). Most patients were female (86.5%), with a median age of 45.5 (IQR: 29–58) years. The TAPSE/sPAP ratio for the whole group was 0.26 (IQR: 0.190–0.347) mm/mmHg, which was similar among different aetiologies, but different between deceased and surviving patients (0.14 vs. 0.27 mm/mmHg, respectively, P