Prognostic impact of the tricuspid annular plane systolic excursion/pulmonary arterial systolic pressure ratio in acute pulmonary embolism

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dc.contributor.authorKültürsay, Barkın
dc.contributor.authorKeskin, Berhan
dc.contributor.authorTanyeri, Seda
dc.contributor.authorKülahçıoğlu, Şeyhmus
dc.contributor.authorHakgör, Aykun
dc.contributor.authorMutlu, Deniz
dc.contributor.authorKaymaz, Cihangir
dc.date.accessioned2025-10-01T10:07:33Z
dc.date.available2025-10-01T10:07:33Z
dc.date.issued2024
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Kardiyoloji Ana Bilim Dalı
dc.description.abstractBackground: Currently available risk stratification models for acute pulmonary embolism (PE) include hemodynamic status, cardiac biomarkers, right ventricle (RV) dysfunction on imaging, and clinical scores. Focusing on the length–tension relationship of the ventricle might have a superior predictive capability over RV dysfunction in terms of mortality and classification of patients with acute PE. In this study, our hypothesis suggests that the tricuspid annular plane systolic excursion (TAPSE)/systolic pulmonary artery pressure (sPAP) ratio has superior predictive capability for in-hospital mortality in patients with acute PE compared to TAPSE or sPAP as distinct measures. Methods: This single-center study comprised retrospectively evaluated 703 patients referred to our tertiary cardiovascular center with acute PE. We divided patients into quartiles based on the TAPSE/sPAP ratio. Different models were developed to quantify the predictive relationship between in-hospital death and echocardiographic measurements. A base model was created with variables including risk status and RV/LV ratio >1. Then, to evaluate the predictive contribution of each measurement; TAPSE/sPAP, TAPSE, and sPAP were sequentially added to the base model. After that, the performance of each model was evaluated. Results: Predictive and discriminative power was the highest in model containing TAPSE/ sPAP. There was still a significant inverse association between TAPSE/sPAP and the risk of in-hospital death even after adjusting for risk status and RV/LV ratio >1. Receiver operating characteristic curve analysis for TAPSE/sPAP revealed the best cut-off value as 0.34. Conclusion: The outcomes of our study reveal that the ratio of TAPSE/sPAP serves as a more potent predictor of mortality than either of the 2 measurements taken separately. The interpretation and utilization of the TAPSE/sPAP cut-off value in acute PE can assist in identifying patients at risk of deterioration and guide the consideration of more intensive treatment options across all risk groups.
dc.identifier.citationKültürsay, B., Keskin, B., Tanyeri, S., Külahçıoğlu, Ş., Hakgör, A., Mutlu, D. ... Kaymaz, C. (2024). Prognostic impact of the tricuspid annular plane systolic excursion/pulmonary arterial systolic pressure ratio in acute pulmonary embolism. Anatolian Journal of Cardiology, 28(10), 479-485. http://dx.doi.org/10.14744/AnatolJCardiol.2024.4110
dc.identifier.doi10.14744/AnatolJCardiol.2024.4110
dc.identifier.endpage485
dc.identifier.issn2149-2263
dc.identifier.issn2149-2271
dc.identifier.issue10
dc.identifier.pmid39189998
dc.identifier.scopus2-s2.0-85205960854
dc.identifier.scopusqualityQ3
dc.identifier.startpage479
dc.identifier.urihttp://dx.doi.org/10.14744/AnatolJCardiol.2024.4110
dc.identifier.urihttps://hdl.handle.net/20.500.12511/13067
dc.identifier.volume28
dc.identifier.wosWOS:001343396700004
dc.identifier.wosqualityQ3
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorHakgör, Aykun
dc.institutionauthorid0000-0001-8252-0373
dc.language.isoen
dc.relation.ispartofAnatolian Journal of Cardiology
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.rightsAttribution-NonCommercial 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0/
dc.subjectEchocardiography
dc.subjectPulmonary Embolism
dc.subjectRight Ventricular Function
dc.subjectRisk Stratification
dc.titlePrognostic impact of the tricuspid annular plane systolic excursion/pulmonary arterial systolic pressure ratio in acute pulmonary embolism
dc.typeArticle

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