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23.09.2022 | Original articles

Early echocardiographic evaluation of right ventricular load adaptability after sequential combination treatment in pulmonary arterial hypertension

verfasst von: Kadriye Memic Sancar, M.D., Mustafa Yildiz, M.D., M.D., Serkan Kahraman, M.D., Begum Uygur, M.D., Umit Bulut, M.D., Meltem Tekin, M.D., Arda Guler, Nail Guven Serbest, M.D., Seda Tukenmez Karakurt, Banu Sahin Yildiz, M.D., Ahmet Yasar Cizgici, M.D., Muhammed Bayram, M.D., Mehmet Erturk, M.D.

Erschienen in: Herz | Ausgabe 4/2023

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Abstract

Background

Using the tricuspid annular plane systolic excursion (TAPSE)/pulmonary arterial systolic pressure (PASP) ratio as an index of right ventricular load adaptability, we aimed to evaluate early changes in right heart contractile function of patients with group 1 pulmonary artery hypertension (PAH) after sequential combination PAH-specific therapy.

Methods

A total of 49 patients with group 1 PAH and 31 control participants were included in the study. The baseline clinical and echocardiographic data of the control and PAH group were compared. Subsequently, clinical and echocardiographic data of PAH patients before treatment and at 6 months after PAH-specific treatment were analyzed.

Results

A significant increase in the TAPSE/PASP ratio was found in patients at 6 months of PAH-specific treatment (0.25 ± 0.14; 0.33 ± 0.16, p < 0.001). Right atrial pressure (8 mm Hg [5–10]; 5 mm Hg [3–8], p < 0.001) and PASP (80.8 ± 30.6 mm Hg; 65.9 ± 25.7 mm Hg, p < 0.001) were significantly lower after sequential combination PAH-specific therapy. Negative correlations were found between the TAPSE/PASP ratio and N‑terminal pro-B-type natriuretic peptide (r = −0.524, p < 0.001), tricuspid regurgitation velocity (r = −0.749, p < 0.001), right atrial area (r = −0.298, p = 0.037), and right atrial pressure (r = −0.463, p = 0.001).

Conclusion

In patients with group 1 PAH, echocardiographic evaluation at the early stage of treatment (6 months) shows a significant improvement in the TAPSE/PASP ratio indicating right ventricular load adaptation. Comprehensive studies are needed on the routine use of the TAPSE/PASP ratio in the risk assessment of PAH patients.

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Titel: Early echocardiographic evaluation of right ventricular load adaptability after sequential combination treatment in pulmonary arterial hypertension
verfasst von: Kadriye Memic Sancar, M.D.
Mustafa Yildiz, M.D., M.D.
Serkan Kahraman, M.D.
Begum Uygur, M.D.
Umit Bulut, M.D.
Meltem Tekin, M.D.
Arda Guler
Nail Guven Serbest, M.D.
Seda Tukenmez Karakurt
Banu Sahin Yildiz, M.D.
Ahmet Yasar Cizgici, M.D.
Muhammed Bayram, M.D.
Mehmet Erturk, M.D.
Publikationsdatum: 23.09.2022
Verlag: Springer Medizin
Erschienen in: Herz / Ausgabe 4/2023
Print ISSN: 0340-9937
Elektronische ISSN: 1615-6692
DOI: https://doi.org/10.1007/s00059-022-05139-1

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Early echocardiographic evaluation of right ventricular load adaptability after sequential combination treatment in pulmonary arterial hypertension