Heart failure & cardiomyopathies
Right ventricular to pulmonary artery coupling and outcome in patients with cardiac amyloidosis
Main finding · All-cause death or HF hospitalizationResult — go to the resultHazard ratio 1.98 95% CI 1.32–2.96Authors' conclusion
In patients with CA, RV-PA coupling predicted the risk of mortality or HF hospitalization. The TAPSE/PASP ratio was more effective than TAPSE or PASP in predicting prognosis.
Study context
- Population
- Patients with ATTR or AL cardiac amyloidosis, 3 Italian high-volume centres53% ATTR-CA, 47% AL-CA
- Participants
- 283 patients
- Exposure
- TAPSE/PASP ratio <0.45 vs ≥0.45
- Outcome
- All-cause death or HF hospitalization
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
Hazard ratio
1.98
95% CI 1.32–2.96
P = 0.001
TAPSE/PASP <0.45vs TAPSE/PASP ≥0.45
HR 1.98 (95% CI 1.32–2.96); P = 0.001
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| All-cause deathIndependently associated | 2.18 (1.31–3.62) | P = 0.003 | |
| 0.20.5125Hazard ratio (log scale) |
Risk reclassification by TAPSE/PASP ratio (net reclassification index)
- NRI, all-cause death or heart failure (HF) hospitalization
- 0.46 (95% CI 0.18-0.74) P = 0.001
- NRI, all-cause death
- 0.49 (0.22-0.77) P < 0.001
- TAPSE or PASP alone did not reclassify risk
- all P > 0.05
All-cause death or HF hospitalization, by cardiac amyloidosis (CA) type (subgroup)
- AL-CA: HR for composite endpoint, TAPSE/PASP ratio
- 2.47, 95% CI 1.58-3.85; P < 0.001
- ATTR-CA: HR for composite endpoint, TAPSE/PASP ratio
- 1.81, 95% CI 1.11-2.95; P = 0.017
Optimal TAPSE/PASP cut-off for predicting prognosis (ROC)
- Optimal cut-off
- 0.47 mm/mmHg
Original publication
Right ventricular to pulmonary artery coupling and outcome in patients with cardiac amyloidosis. Eur Heart J Cardiovasc Imaging. Published 28 June 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →