Valvular & structural heart disease
Artificial intelligence–enabled assessment of right ventricular to pulmonary artery coupling in patients undergoing transcatheter tricuspid valve intervention
Authors' conclusion
Artificial intelligence-enabled RV-PA coupling assessment can refine risk stratification prior to TTVI without necessitating invasive right heart catheterization.
Study context
- Population
- Patients undergoing transcatheter tricuspid valve intervention (transcatheter tricuspid valve interventions (TTVI)) for severe tricuspid regurgitation55 for external validation
- Participants
- 737 patients
- Exposure
- Tricuspid annular plane systolic excursion (TAPSE)/mPAPpredicted vs TAPSE/sPAPechocardiography
- Outcome
- Prediction of 2-year mortality after TTVI
- Follow-up
- 2 years
Methodological detailsmulticentre, external validation, machine learning (extreme gradient boosting)
- Multicentre
- External validation
- Machine learning (extreme gradient boosting)
Main finding
As reported in the abstract
Prediction of 2-year mortality
| Group | AUC |
|---|---|
| TAPSE/mPAPpredicted | 0.633 |
| TAPSE/sPAPechocardiography | 0.586 |
AUC
TAPSE/mPAPpredicted0.633
TAPSE/sPAPechocardiography0.586
- TAPSE/mPAPpredicted vs TAPSE/sPAPechocardiography: P value: 0.008
Observational data: associations, not effects.
Further findings
| Outcome | TAPSE/mPAPpredicted | TAPSE/sPAPechocardiography | P value |
|---|---|---|---|
| mPAPpredicted vs sPAPechocardiography for predicting 2-year mortality | P value: 1.9 × 10-6 | ||
| AUC | 0.607 | 0.520 | |
| 2-year survival by RV-PA coupling (preserved: TAPSE/mPAPpredicted > 0.617 mm/mmHg) | P < 0.001 |
- 2-year survival by right ventricular to pulmonary artery (RV-PA) coupling (preserved: TAPSE/mPAPpredicted > 0.617 mm/mmHg): Preserved RV-PA coupling 81.5%
- 2-year survival by RV-PA coupling (preserved: TAPSE/mPAPpredicted > 0.617 mm/mmHg): Reduced RV-PA coupling 58.8%
Agreement of XGB-predicted mean pulmonary artery pressure (mPAP) with right heart catheterization mPAP (external validation)
- Pearson correlation coefficient R
- 0.68
- P value
- 1.3 × 10-8
Independent association of TAPSE/mPAPpredicted with 2-year mortality (multivariate regression)
- Independent association confirmed
- P value: 6.3 × 10-4
Original publication
Artificial intelligence–enabled assessment of right ventricular to pulmonary artery coupling in patients undergoing transcatheter tricuspid valve intervention. Eur Heart J Cardiovasc Imaging. Published 23 November 2023. doi:10.
Summarised from the published abstract; every number is checked against it