PROGNOSTIC USEFULNESS OF NONINVASIVELY ASSESSED RIGHT VENTRICULAR-PULMONARY ARTERY COUPLING IN PATIENTS WITH RECENTLY DIAGNOSED UNEXPLAINED LV SYSTOLIC DYSFUNCTION.

Introduction: The ratio of tricuspid annular plane systolic excursion/systolic pulmonary artery pressure (TAPSE/PASP) measured by echocardiography has been proposed as a noninvasive index of right ventricular–pulmonary artery coupling with prognostic implications in heart failure patients.
The aim of the study: To assess the prognostic usefulness of TAPSE/PASP ratio in patients with recently diagnosed unexplained LV systolic dysfunction.
Methods: We retrospectively assessed echocardiographic, laboratory and clinical data in 133 patients with recently diagnosed unexplained LV systolic dysfunction (55±11 years, 72 % males) with symptoms lasting <6 months. A comprehensive echocardiographic examination was performed at the time of diagnosis including the evaluation of TAPSE and PASP, respectively.
Results: During a median follow-up of 5 years, 23 subjects died (17 % of total initial study population). In univariate analysis, overall survival was associated with right atrial (RA) area, RA pressure, tricuspid regurgitation grade, E/e´, PR interval duration and BNP level, but not with TAPSE/PAPS ratio (p=0.215). In multivariate analysis of echocardiographic parameters, only RA area was found to be independently associated with mortality (p ‹0.05). TAPSE/PASP was not associated with prognosis.
Conclusions: TAPSE/PASP ratio is not associated with survival in patients with recently diagnosed unexplained LV systolic dysfunction. RA area appears to be a significant echocardiographic predictor of 5-year survival in these individuals.