Prognostic value of non-invasive right ventricle-pulmonary artery coupling in patients with pulmonary hypertension associated with left heart disease
Abstract Objective This study aims to assess the prognostic significance of non-invasive right ventricle-pulmonary artery coupling in patients with pulmonary hypertension associated with left heart disease (PH-LHD) and identify the relevant clinical factors involved. Methods A cohort of 362 patients...
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2025-04-01
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| Series: | Journal of Cardiothoracic Surgery |
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| Online Access: | https://doi.org/10.1186/s13019-025-03420-y |
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| author | Ling-Zhi Dou Shan-Shan Li Sen Wang He Jiang Yu-Li Zheng Meng-Meng Duan Yi-Gang Zhang Bing Han Jian-Ming Li Hong-Yun Ruan |
| author_facet | Ling-Zhi Dou Shan-Shan Li Sen Wang He Jiang Yu-Li Zheng Meng-Meng Duan Yi-Gang Zhang Bing Han Jian-Ming Li Hong-Yun Ruan |
| author_sort | Ling-Zhi Dou |
| collection | DOAJ |
| description | Abstract Objective This study aims to assess the prognostic significance of non-invasive right ventricle-pulmonary artery coupling in patients with pulmonary hypertension associated with left heart disease (PH-LHD) and identify the relevant clinical factors involved. Methods A cohort of 362 patients diagnosed with PH-LHD was included in this study. Plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels were measured using enzyme-linked immunosorbent assay (ELISA). Echocardiography was employed to screen routine ultrasound parameters. The tricuspid annular plane systolic excursion/pulmonary artery systolic pressure (TAPSE/PASP) and S’/PASP ratios were calculated. Participants were categorized into two groups based on the TAPSE/PASP ratio: moderate-to-severe and mild uncoupling groups. Both groups underwent routine follow-up for a period of 3 to 15 months. Clinical events included all-cause mortality, heart failure rehospitalization, and stroke. Clinical events were documented, and a multivariate Cox regression model evaluated the correlation between the TAPSE/PASP ratio and prognosis. The Kaplan-Meier survival analysis was also conducted. Results The moderate-to-severe uncoupling group exhibited significantly higher proportions of males; individuals with a history of smoking, valvular disease, diabetes mellitus, or stroke; and elevated levels of PASP, right ventricular diameter (RVD), left ventricular diameter (LVD), left ventricular end-diastolic (LVED), and lg (NT-proBNP) compared to the mild uncoupling group (P < 0.05). Conversely, parameters such as age, TAPSE, S’, S’ /PASP, and left ventricular ejection fraction (LVEF) were significantly lower in the moderate-to-severe uncoupling group compared to the mild uncoupling group (P < 0.05). Multivariate Cox regression analysis revealed that TAPSE/PASP (hazard ratio [HR] = 0.150, 95% confidence interval [CI] [0.023, 0.968], P = 0.046) was a protective factor for the recurrence of clinical events. In contrast, LVED (HR = 1.301, 95% CI (1.004, 1.059), P = 0.024) and lg (NT-proBNP) (HR = 1.870, 95%CI [1.304, 2.682], P = 0.001) were independent risk factors for the recurrence of clinical events. KaplanMeier survival analysis demonstrated that the mild uncoupling group exhibited a significantly higher overall survival rate compared to the moderate-to-severe uncoupling group (Log Rank P = 0.024). Conclusions The TAPSE/PASP ratio is a predictive marker for clinical outcomes in patients with PH-LHD. |
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| id | doaj-art-6e3ca81a1e4d4e05a49396980f50a9d2 |
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| spelling | doaj-art-6e3ca81a1e4d4e05a49396980f50a9d22025-08-20T02:17:13ZengBMCJournal of Cardiothoracic Surgery1749-80902025-04-012011810.1186/s13019-025-03420-yPrognostic value of non-invasive right ventricle-pulmonary artery coupling in patients with pulmonary hypertension associated with left heart diseaseLing-Zhi Dou0Shan-Shan Li1Sen Wang2He Jiang3Yu-Li Zheng4Meng-Meng Duan5Yi-Gang Zhang6Bing Han7Jian-Ming Li8Hong-Yun Ruan9Department of Cardiology, Xuzhou Central HospitalDepartment of Cardiology, Xuzhou Central HospitalDepartment of Cardiology, Xuzhou Central HospitalDepartment of Cardiology, Xuzhou Central HospitalDepartment of Cardiology, Xuzhou Central HospitalGraduate School of Bengbu Medical CollegeDepartment of Cardiology, Xuzhou Central HospitalDepartment of Cardiology, Xuzhou Central HospitalDepartment of Cardiac Surgery, Xuzhou Central HospitalDepartment of Cardiology, Xuzhou Central HospitalAbstract Objective This study aims to assess the prognostic significance of non-invasive right ventricle-pulmonary artery coupling in patients with pulmonary hypertension associated with left heart disease (PH-LHD) and identify the relevant clinical factors involved. Methods A cohort of 362 patients diagnosed with PH-LHD was included in this study. Plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels were measured using enzyme-linked immunosorbent assay (ELISA). Echocardiography was employed to screen routine ultrasound parameters. The tricuspid annular plane systolic excursion/pulmonary artery systolic pressure (TAPSE/PASP) and S’/PASP ratios were calculated. Participants were categorized into two groups based on the TAPSE/PASP ratio: moderate-to-severe and mild uncoupling groups. Both groups underwent routine follow-up for a period of 3 to 15 months. Clinical events included all-cause mortality, heart failure rehospitalization, and stroke. Clinical events were documented, and a multivariate Cox regression model evaluated the correlation between the TAPSE/PASP ratio and prognosis. The Kaplan-Meier survival analysis was also conducted. Results The moderate-to-severe uncoupling group exhibited significantly higher proportions of males; individuals with a history of smoking, valvular disease, diabetes mellitus, or stroke; and elevated levels of PASP, right ventricular diameter (RVD), left ventricular diameter (LVD), left ventricular end-diastolic (LVED), and lg (NT-proBNP) compared to the mild uncoupling group (P < 0.05). Conversely, parameters such as age, TAPSE, S’, S’ /PASP, and left ventricular ejection fraction (LVEF) were significantly lower in the moderate-to-severe uncoupling group compared to the mild uncoupling group (P < 0.05). Multivariate Cox regression analysis revealed that TAPSE/PASP (hazard ratio [HR] = 0.150, 95% confidence interval [CI] [0.023, 0.968], P = 0.046) was a protective factor for the recurrence of clinical events. In contrast, LVED (HR = 1.301, 95% CI (1.004, 1.059), P = 0.024) and lg (NT-proBNP) (HR = 1.870, 95%CI [1.304, 2.682], P = 0.001) were independent risk factors for the recurrence of clinical events. KaplanMeier survival analysis demonstrated that the mild uncoupling group exhibited a significantly higher overall survival rate compared to the moderate-to-severe uncoupling group (Log Rank P = 0.024). Conclusions The TAPSE/PASP ratio is a predictive marker for clinical outcomes in patients with PH-LHD.https://doi.org/10.1186/s13019-025-03420-yLeft heart disease (LHD)N-terminal pro-B-type natriuretic peptide (NT-proBNP)PrognosisPulmonary hypertension (PH)Right ventricle-pulmonary artery (RV-PA) couplingTricuspid annular plane systolic excursion/pulmonary artery systolic pressure (TAPSE/PASP) ratio |
| spellingShingle | Ling-Zhi Dou Shan-Shan Li Sen Wang He Jiang Yu-Li Zheng Meng-Meng Duan Yi-Gang Zhang Bing Han Jian-Ming Li Hong-Yun Ruan Prognostic value of non-invasive right ventricle-pulmonary artery coupling in patients with pulmonary hypertension associated with left heart disease Journal of Cardiothoracic Surgery Left heart disease (LHD) N-terminal pro-B-type natriuretic peptide (NT-proBNP) Prognosis Pulmonary hypertension (PH) Right ventricle-pulmonary artery (RV-PA) coupling Tricuspid annular plane systolic excursion/pulmonary artery systolic pressure (TAPSE/PASP) ratio |
| title | Prognostic value of non-invasive right ventricle-pulmonary artery coupling in patients with pulmonary hypertension associated with left heart disease |
| title_full | Prognostic value of non-invasive right ventricle-pulmonary artery coupling in patients with pulmonary hypertension associated with left heart disease |
| title_fullStr | Prognostic value of non-invasive right ventricle-pulmonary artery coupling in patients with pulmonary hypertension associated with left heart disease |
| title_full_unstemmed | Prognostic value of non-invasive right ventricle-pulmonary artery coupling in patients with pulmonary hypertension associated with left heart disease |
| title_short | Prognostic value of non-invasive right ventricle-pulmonary artery coupling in patients with pulmonary hypertension associated with left heart disease |
| title_sort | prognostic value of non invasive right ventricle pulmonary artery coupling in patients with pulmonary hypertension associated with left heart disease |
| topic | Left heart disease (LHD) N-terminal pro-B-type natriuretic peptide (NT-proBNP) Prognosis Pulmonary hypertension (PH) Right ventricle-pulmonary artery (RV-PA) coupling Tricuspid annular plane systolic excursion/pulmonary artery systolic pressure (TAPSE/PASP) ratio |
| url | https://doi.org/10.1186/s13019-025-03420-y |
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