Pulmonary vascular disease & thromboembolism
Right ventricular-pulmonary artery coupling for prognostication in acute pulmonary embolism
Authors' conclusion
Decreased TAPSE/PASP ratio was associated with increased mortality.
Study context
- Population
- Haemodynamically stable patients with acute pulmonary embolism (PE), RIETE registry
- Participants
- 4,478 patients
- Exposure
- Tricuspid annular plane systolic excursion (TAPSE)/pulmonary arterial systolic pressure (PASP) ratio across European Society of Cardiology (ESC) risk strata
- Low riskn = 1,326
- Intermediate-low riskn = 2,425
- Intermediate-high riskn = 727
- Outcome
- All-cause mortality
- Follow-up
- 30 days
Methodological detailsconsecutive patients, multivariable logistic regression
- Consecutive patients
- Multivariable logistic regression
Main finding
As reported in the abstract
30-day all-cause mortality by TAPSE/PASP ratio
Estimate (95% CI)
Per 0.1 decrease in TAPSE/PASPall patients
adjusted OR 1.32(1.14–1.52)
TAPSE/PASP <0.40Low risk
aOR 5.88(1.63–21.2)
TAPSE/PASP <0.43Intermediate-low risk
aOR 2.96(1.54–5.71)
TAPSE/PASP <0.34Intermediate-high risk
aOR 4.37(1.27–15.0)
Per 0.1 decrease in TAPSE/PASP, as printed
Observational data: associations, not effects.
Further findings
| Outcome | Net reclassification improvement (95% CI) |
|---|---|
| Net reclassification improvement of TAPSE/PASP <0.44TAPSE/PASP <0.44 vs RV/LV ratio >1 | 18.2% (0.61–35.8) |
| Net reclassification improvement of TAPSE/PASP <0.44TAPSE/PASP <0.44 vs ESC risk strata | 27.7% (10.2–45.1) |
Original publication
Right ventricular-pulmonary artery coupling for prognostication in acute pulmonary embolism. Eur Heart J Acute Cardiovasc Care. Published 24 October 2024. doi:10.
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