Abstract
Objective. The tricuspid annular plane systolic excursion (TAPSE) strongly reflects right ventricular (RV) function and predicts survival in idiopathic pulmonary arterial hypertension (PAH). But its role in systemic sclerosis (SSc)-associated PAH has not been established. Our objective was to validate the TAPSE in the assessment of RV function and prediction of survival in SSc-PAH. Methods. Fifty consecutive patients with SSc-PAH who underwent echocardiography with TAPSE measurement within 1 h of clinically indicated right heart catheterization were followed prospectively. The relationship between TAPSE and measures of RV function and measures of survival was assessed. Results. The majority of the cohort were women in New York Heart Association class III/IV with severe PAH (mean cardiac index 2.4 ± 0.8 l/min/m 2). RV function was significantly impaired (mean cardiac index 2.1 ± 0.7 vs 2.9 ± 0.8 l/min/m 2; p <0.01) and RV afterload was significantly greater (mean pulmonary vascular resistance 11.1 ± 5.1 vs 5.8 ± 2.5 Wood units; p <0.01) in subjects with a TAPSE ≤ 1.7 cm. The proportion surviving in the low TAPSE group was significantly lower [0.56 (95% CI 0.37-0.71) and 0.46 (95% CI 0.28-0.62) vs 0.87 (95% CI 0.55-0.96) and 0.79 (95% CI 0.49-0.93), 1- and 2-year survival, respectively]. TAPSE ≤ 1.7 cm conferred a nearly 4-fold increased risk of death (HR 3.81, 95% CI 1.31-11.1, p <0.01). Conclusion. TAPSE is a robust measure of RV function and strongly predicts survival in patients with PAH-SSc. Future studies are needed to identify the responsiveness of TAPSE to PAH-specific therapy and to assess its diagnostic utility in PAH-SSc. The Journal of Rheumatology
| Original language | English (US) |
|---|---|
| Pages (from-to) | 2410-2418 |
| Number of pages | 9 |
| Journal | Journal of Rheumatology |
| Volume | 38 |
| Issue number | 11 |
| DOIs | |
| State | Published - Nov 2011 |
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Keywords
- Echocardiography
- Pulmonary hypertension
- Survival
- Systemic sclerosis
ASJC Scopus subject areas
- Rheumatology
- Immunology
- Immunology and Allergy
Cite this
Tricuspid annular plane systolic excursion is a robust outcome measure in systemic sclerosis-associated pulmonary arterial hypertension. / Mathai, Stephen C.; Sibley, Christopher; Forfia, Paul R.; Mudd, James; Fisher, Micah R.; Tedford, Ryan J.; Lechtzin, Noah; Boyce, Danielle; Hummers, Laura K.; Housten, Traci; Zaiman, Ari L.; Girgis, Reda E.; Hassoun, Paul M.
In: Journal of Rheumatology, Vol. 38, No. 11, 11.2011, p. 2410-2418.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Tricuspid annular plane systolic excursion is a robust outcome measure in systemic sclerosis-associated pulmonary arterial hypertension
AU - Mathai, Stephen C.
AU - Sibley, Christopher
AU - Forfia, Paul R.
AU - Mudd, James
AU - Fisher, Micah R.
AU - Tedford, Ryan J.
AU - Lechtzin, Noah
AU - Boyce, Danielle
AU - Hummers, Laura K.
AU - Housten, Traci
AU - Zaiman, Ari L.
AU - Girgis, Reda E.
AU - Hassoun, Paul M.
PY - 2011/11
Y1 - 2011/11
N2 - Objective. The tricuspid annular plane systolic excursion (TAPSE) strongly reflects right ventricular (RV) function and predicts survival in idiopathic pulmonary arterial hypertension (PAH). But its role in systemic sclerosis (SSc)-associated PAH has not been established. Our objective was to validate the TAPSE in the assessment of RV function and prediction of survival in SSc-PAH. Methods. Fifty consecutive patients with SSc-PAH who underwent echocardiography with TAPSE measurement within 1 h of clinically indicated right heart catheterization were followed prospectively. The relationship between TAPSE and measures of RV function and measures of survival was assessed. Results. The majority of the cohort were women in New York Heart Association class III/IV with severe PAH (mean cardiac index 2.4 ± 0.8 l/min/m 2). RV function was significantly impaired (mean cardiac index 2.1 ± 0.7 vs 2.9 ± 0.8 l/min/m 2; p <0.01) and RV afterload was significantly greater (mean pulmonary vascular resistance 11.1 ± 5.1 vs 5.8 ± 2.5 Wood units; p <0.01) in subjects with a TAPSE ≤ 1.7 cm. The proportion surviving in the low TAPSE group was significantly lower [0.56 (95% CI 0.37-0.71) and 0.46 (95% CI 0.28-0.62) vs 0.87 (95% CI 0.55-0.96) and 0.79 (95% CI 0.49-0.93), 1- and 2-year survival, respectively]. TAPSE ≤ 1.7 cm conferred a nearly 4-fold increased risk of death (HR 3.81, 95% CI 1.31-11.1, p <0.01). Conclusion. TAPSE is a robust measure of RV function and strongly predicts survival in patients with PAH-SSc. Future studies are needed to identify the responsiveness of TAPSE to PAH-specific therapy and to assess its diagnostic utility in PAH-SSc. The Journal of Rheumatology
AB - Objective. The tricuspid annular plane systolic excursion (TAPSE) strongly reflects right ventricular (RV) function and predicts survival in idiopathic pulmonary arterial hypertension (PAH). But its role in systemic sclerosis (SSc)-associated PAH has not been established. Our objective was to validate the TAPSE in the assessment of RV function and prediction of survival in SSc-PAH. Methods. Fifty consecutive patients with SSc-PAH who underwent echocardiography with TAPSE measurement within 1 h of clinically indicated right heart catheterization were followed prospectively. The relationship between TAPSE and measures of RV function and measures of survival was assessed. Results. The majority of the cohort were women in New York Heart Association class III/IV with severe PAH (mean cardiac index 2.4 ± 0.8 l/min/m 2). RV function was significantly impaired (mean cardiac index 2.1 ± 0.7 vs 2.9 ± 0.8 l/min/m 2; p <0.01) and RV afterload was significantly greater (mean pulmonary vascular resistance 11.1 ± 5.1 vs 5.8 ± 2.5 Wood units; p <0.01) in subjects with a TAPSE ≤ 1.7 cm. The proportion surviving in the low TAPSE group was significantly lower [0.56 (95% CI 0.37-0.71) and 0.46 (95% CI 0.28-0.62) vs 0.87 (95% CI 0.55-0.96) and 0.79 (95% CI 0.49-0.93), 1- and 2-year survival, respectively]. TAPSE ≤ 1.7 cm conferred a nearly 4-fold increased risk of death (HR 3.81, 95% CI 1.31-11.1, p <0.01). Conclusion. TAPSE is a robust measure of RV function and strongly predicts survival in patients with PAH-SSc. Future studies are needed to identify the responsiveness of TAPSE to PAH-specific therapy and to assess its diagnostic utility in PAH-SSc. The Journal of Rheumatology
KW - Echocardiography
KW - Pulmonary hypertension
KW - Survival
KW - Systemic sclerosis
UR - http://www.scopus.com/inward/record.url?scp=80053469400&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=80053469400&partnerID=8YFLogxK
U2 - 10.3899/jrheum.110512
DO - 10.3899/jrheum.110512
M3 - Article
C2 - 21965638
AN - SCOPUS:80053469400
VL - 38
SP - 2410
EP - 2418
JO - Journal of Rheumatology
JF - Journal of Rheumatology
SN - 0315-162X
IS - 11
ER -