Valvular & structural heart disease

Pulmonary Artery Pulsatility Index and Clinical Outcomes in Patients Undergoing Transcatheter Tricuspid Valve Replacement

JACC Cardiovasc IntervPublished Retrospective cohort study

Corrected 23 Oct 2026: Measure wording clarified; no values changed.

Authors' conclusion

In patients undergoing TTVR, low preprocedural PAPI identifies a high-risk phenotype, and it is independently associated with adverse outcomes.

Study context

Population
Patients with severe tricuspid regurgitation undergoing orthotopic transcatheter tricuspid valve replacement (TTVR) with preprocedural right heart catheterization data
Participants
94 patients
Exposure
Low pulmonary artery pulsatility index (PAPI) vs high PAPI
  • Low PAPIn = 28
Outcome
Composite of:
  • All-cause mortality
  • HF hospitalization
Follow-up
2-year follow-up
Methodological detailsMedian follow-up 491 days (Q1-Q3: 227-879 days)
  • Median follow-up 491 days (Q1-Q3: 227-879 days)

Main finding

As reported in the abstract

Survival free from composite endpoint (Kaplan-Meier)

HR for the composite of all-cause mortality and heart failure hospitalization

2.50

95% CI 1.18–5.27

P = 0.018

By group

Low PAPIvs High PAPI
HR for the composite of all-cause mortality and heart failure hospitalization 2.50 (95% CI 1.18–5.27); P = 0.018

Observational data: associations, not effects.

Further findings

OutcomeLow PAPIHigh PAPIP value
Survival free from all-cause mortality (Kaplan-Meier)52.6% (95% CI 30.2%–91.7%)87.6% (95% CI 79.2%–96.9%)P = 0.006
Survival free from HF hospitalization (Kaplan-Meier)49.1% (95% CI 28.4%–85.1%)76.6% (95% CI 65.4%–89.6%)P = 0.017

Original publication

Pulmonary Artery Pulsatility Index and Clinical Outcomes in Patients Undergoing Transcatheter Tricuspid Valve Replacement. JACC Cardiovasc Interv. Published 11 May 2026. doi:10.1016/j.jcin.2026.04.021

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