ArticleBMC cardiovascular disorders2026
TAPSE/PAi, a practical echocardiographic functional-structural index, better reflects functional severity than TAPSE/sPAP in pulmonary hypertension.
Article in BMC cardiovascular disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundWe evaluated TAPSE/PAi, defined as the ratio of tricuspid annular plane systolic excursion to the indexed main pulmonary artery diameter, as a pragmatic functional-structural index and compared it with TAPSE/sPAP.
methodsIn this retrospective study, 53 patients with PAH were analyzed. Associations of TAPSE/PAi and TAPSE/sPAP with clinical, biomarker, and invasive hemodynamic variables were assessed. Discrimination for WHO-FC ≥ 3, 6MWD < 165 m, and PVR > 5 WU was evaluated by direction-aligned ROC analysis with Youden-optimal thresholds. Age- and sex-adjusted logistic regression models reported odds ratios (ORs) per 1-SD increase.
resultsTAPSE/PAi correlated more strongly than TAPSE/sPAP with WHO-FC (ρ=-0.592 vs. -0.384) and 6MWD (ρ = 0.493 vs. 0.378), whereas TAPSE/sPAP correlated more strongly with NT-proBNP/proBNP (ρ=-0.619 vs. -0.484) and with mPAP/PVR. TAPSE/PAi showed better discrimination for WHO-FC ≥ 3 and 6MWD < 165 m while TAPSE/sPAP performed modestly better for PVR > 5 WU The Youden-optimal TAPSE/PAi threshold was ≤ 1.296 for both WHO-FC ≥ 3 and 6MWD < 165 m. The higher TAPSE/PAi remained associated with lower odds of WHO-FC ≥ 3 and 6MWD < 165 m after age- and sex-adjustment.
conclusionsTAPSE/PAi better reflects functional severity and exercise limitation, whereas TAPSE/sPAP is more closely related to biomarker/hemodynamic burden. The indices appear complementary, and TAPSE/PAi may be a practical TR-independent severity marker in PAH.
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