ArticleEuropean heart journal. Acute cardiovascular care2024
Right ventricular-pulmonary artery coupling for prognostication in acute pulmonary embolism.
Article in European heart journal. Acute cardiovascular care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Right ventricular-pulmonary arterial uncoupling and venous excess in normotensive pulmonary embolism shock.Critical care (London, England) · 2026Article
- Right Ventricular Global Longitudinal Strain and 30-Day Mortality in Intermediate-Risk Pulmonary Embolism: An External Validation Study.Echocardiography (Mount Kisco, N.Y.) · 2026Article
- Acute pulmonary embolism: clinical and echocardiographic recognition of normotensive shock.Critical care (London, England) · 2026Article
- Admission Endothelial Activation and Stress Index and Echocardiographic RV-PA Coupling for Early Risk Stratification in Intermediate-Risk Acute Pulmonary Embolism.Journal of clinical medicine · 2026Article
- Early versus delayed EKOS thrombolysis in intermediate-high risk pulmonary embolism: a retrospective multicentre analysis.Open heart · 2026Article
- Preoperative Right Ventricle-to-Pulmonary Artery Coupling Correlates With Intensive Care Length of Stay After Pulmonary Endarterectomy.Journal of cardiothoracic and vascular anesthesia · 2026Article
- Intermediate-Risk Pulmonary Embolism: Patients' Stratification, Prognosis, and Therapeutic Options-Time to Pay Attention to the Middle Child.Journal of clinical medicine · 2025Review
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12 authors.
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Abstract
aimsAcute pulmonary embolism (PE) increases pulmonary pressure and impair right ventricular (RV) function. Echocardiographic investigation can quantify this mismatch as the tricuspid annular plane systolic excursion (TAPSE) to pulmonary arterial systolic pressure (PASP) ratio. The aim of the study was to investigate the prognostic capabilities of TAPSE/PASP ratio in patients with acute PE. METHODS AND
resultsWe utilized the Registro Informatizado Enfermedad TromboEmbolica registry to analyse consecutive haemodynamically stable PE patients. We used multi-variable logistic regression analyses to assess the association between the TAPSE/PASP ratio and 30-day all-cause mortality across the strata of European Society of Cardiology (ESC) risk categories. We included 4478 patients, of whom 1326 (30%) had low-risk, 2425 (54%) intermediate-low risk and 727 (16%) intermediate-high risk PE. Thirty-day mortality rates were 0.7%, 2.3% and 3.4%, respectively. Mean TAPSE/PASP ratio was 0.65 ± 0.29 in low-risk patients, 0.46 ± 0.30 in intermediate-low risk and 0.33 ± 0.19 in intermediate-high risk patients. In multi-variable analyses, there was an inverse association between TAPSE/PASP ratio and 30-day mortality (adjusted OR 1.32 [95% CI 1.14-1.52] per 0.1 decrease in TAPSE/PASP). TAPSE/PASP ratio below optimal cut-points was associated with increased mortality in low- (<0.40, aOR: 5.88; 95% CI: 1.63-21.2), intermediate-low (<0.43, aOR: 2.96; 95% CI: 1.54-5.71) and intermediate-high risk patients (<0.34, aOR: 4.37; 95% CI: 1.27-15.0). TAPSE/PASP <0.44 showed net reclassification improvement of 18.2% (95% CI: 0.61-35.8) vs. RV/LV ratio >1, and 27.7% (95% CI: 10.2-45.1) vs. ESC risk strata.
conclusionDecreased TAPSE/PASP ratio was associated with increased mortality. The ratio may aid in clinical decision-making, particularly for intermediate-risk patients for whom the discriminatory capability of the current risk stratification tools is limited.
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