Valvular & structural heart disease
Right ventricular–pulmonary artery coupling in patients with tricuspid valve regurgitation: use of echo-derived pulmonary artery effective elastance
Authors' conclusion
In patients with significant TR, higher PA Ea is progressively associated with RV dysfunction, right heart failure, and worse survival. Incorporating PA Ea into the routine echo assessment may help stratify risk.
Study context
- Population
- Patients with ≥moderate TR
- Participants
- 12,682 patients
- Comparison
- All-cause mortality at 5 years based on the pulmonary artery (PA) Ea
- Outcome
- PA Ea
Main finding
As reported in the abstract
Median PA Ea
0.7 mm Hg/mL
interquartile range 0.5, 0.9
Further findings
| Outcome | Hazard ratio (95% CI) | P value | |
|---|---|---|---|
| All-cause mortality · 5 yearsHigher risk of death with higher PA Ea · adjusted for age and sex | 1.55 (1.51–1.60) | P < 0.0001 | |
| 0.512Hazard ratio (log scale) |
Clinical associations of increasing PA Ea
- Increasing levels of PA Ea were associated with heart failure, liver and kidney disease, and clinical markers of risk such as the Tricuspid Regurgitation Impact on Outcomes score
Right ventricle (RV) and biomarker associations of increasing PA Ea
- Increasing levels of PA Ea were associated with larger RVs, worse RV systolic function, higher N-terminal pro-brain natriuretic peptide levels, and greater degrees of right heart failure
Multivariable prediction of outcome
- PA Ea was independently predictive of outcome compared with other indexes of RV-PA coupling
- Multivariable modelling incorporating available clinical variables
Original publication
Right ventricular–pulmonary artery coupling in patients with tricuspid valve regurgitation: use of echo-derived pulmonary artery effective elastance. Eur Heart J Cardiovasc Imaging. Published 22 May 2025. doi:10.
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