Tricuspid Annular Plane Systolic Excursion/Pulmonary Arterial Systolic Pressure Ratio as a Predictor of Mortality in Heart Failure Patients
Abdessamad Couissi *
Department of Cardiology, IBN ROCHD University Hospital, Casablanca, Morocco and Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.
Taha Ettachfini
Department of Cardiology, IBN ROCHD University Hospital, Casablanca, Morocco and Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.
Mehdi Rochd
Department of Cardiology, IBN ROCHD University Hospital, Casablanca, Morocco and Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.
Anass Maaroufi
Department of Cardiology, IBN ROCHD University Hospital, Casablanca, Morocco and Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.
Meryem Haboub
Department of Cardiology, IBN ROCHD University Hospital, Casablanca, Morocco and Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.
Rachida Habbal
Department of Cardiology, IBN ROCHD University Hospital, Casablanca, Morocco and Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.
*Author to whom correspondence should be addressed.
Abstract
Aims: We aimed to investigate the prognostic value of the tricuspid annular plane systolic excursion (TAPSE)/ pulmonary arterial systolic pressure (PASP) ratio in Moroccan patients with heart Failure (HF).
Study Design: A retrospective study was conducted in The Cardiology Department of Ibn Rochd Hospital of Casablanca in Morocco. The study was conducted in the period between March 2012 to March 2016 with a follow-up until December 2022.
Methods: data were evaluated from the HF register patients and their relatives were contacted by phone. Patients with reduced LVEF were included, patients with pulmonary embolism, and patients with HFpEF were excluded. The endpoint of the study was mortality.
Results: 128 patients were enrolled Over an average follow-up of 58 months. 51(41.4%) patients died at the end of the follow-up, the median value of left ventricular ejection fraction was 35.2 ± 2.2%. Patients were stratified according to the TAPSE/PASP ratio (low <0.32 mm/mmHg; high: >0.32 mm/mmHg). Kaplan-Meier survival analysis showed that ten-year all-cause mortality was significantly higher in patients with TAPSE/PASP ≤0.32 mm/mmHg than in patients with TAPSE/PASP > 0.32 mm/mmHg (log-rank 7.8, p =0.008) Cox regression analysis revealed that lower LVEF (p= 0.04), and a ratio of TAPSE\PAPS <0.32 (p=0.02) were associated to an increase in all-cause mortality.
Conclusion: Correlating right ventricular function to loading conditions may be more accurate in assessing its real contractility and predicting patients’ outcomes. Our study showed that TAPSE/PASP appears as a novel prognostic predictor in patients with Heart failure.
Keywords: TAPSE, PASP, Chronic heart failure, Morocco, predictors, mortality