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Test Good Predictor of Survival in Pulmonary Hypertension

Non-invasive echo-derived measurement reflects heart function and prognosis

WEDNESDAY, Nov. 1 (HealthDay News) -- Tricuspid annular plane systolic excursion (TAPSE), a non-invasive echo-derived test, is a powerful measure of right heart function that predicts survival in patients with pulmonary arterial hypertension, according to an article in the November issue of the American Journal of Respiratory and Critical Care Medicine.

Paul R. Forfia, M.D., of Johns Hopkins Hospital in Baltimore, and colleagues prospectively evaluated 63 patients with pulmonary hypertension. Patients had right heart catheterization followed by transthoracic echocardiogram and TAPSE measurement.

A TAPSE less than 1.8 cm was linked to increased right ventricular systolic dysfunction, right heart remodeling and right ventricular-left ventricular disproportion, the researchers found. One- and two-year survival estimates were 94 percent and 88 percent, respectively, for those with a TAPSE of 1.8 cm or more. A TAPSE lower than 1.8 cm was linked to a survival rate of 60 percent at one year and 50 percent at two years. Those with more advanced right ventricular dysfunction also had a significantly higher mortality.

"The present study demonstrates that TAPSE is a simple, reproducible, yet robust measure of right ventricular function in patients with pulmonary hypertension, which also has important prognostic implications for patients with pulmonary arterial hypertension. Thus, TAPSE should be incorporated into the echocardiographic assessment of patients with pulmonary arterial hypertension," the authors conclude.

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