Test Gauges Pulmonary Hypertension Risk
Simple heart measurement predicts survival, experts say
WEDNESDAY, Nov. 1, 2006 (HealthDay News) -- A simple, noninvasive test that measures the function of the heart's right ventricle helps predict survival time in adults with dangerous pulmonary hypertension, U.S. researchers report.
Pulmonary hypertension is a progressive narrowing of the blood vessels in the lungs. The condition, which can lead to death, can be difficult to detect in routine medical exams. However, it is known that patients with the greatest degree of right ventricular dysfunction have the most rapid deterioration, according to background information in the study.
This study of 63 pulmonary hypertension patients, average age 55, was led by Dr. Paul H. Hassoun, of the divisions of cardiology, pulmonary and critical care medicine at Johns Hopkins Hospital in Baltimore.
His team used a test called "tricuspid annular plane systolic excursion" (TAPSE) to measure echocardiographic abnormalities in the heart's tricuspid valve, which is located between the heart's right atrium and right ventricle. The valve prevents the backflow of blood as it's pumped from the right atrium to the right ventricle.
"We found that a TAPSE of less than 1.8 cm was associated with a greater ventricular systolic dysfunction, as well as right heart remodeling," Hassoun said in a prepared statement.
"In addition, survival estimates at one and two years for those with pulmonary arterial hypertension were 94 percent and 88 percent, respectively, for individuals with a TAPSE of 1.8 cm or greater. If the TAPSE was less, the survival rates were 60 percent at one year and 50 percent at two years," he said.
Patients with a TAPSE of less than 1.8 cm (showing more advanced right ventricular dysfunction) had significantly lower survival rates over the average follow-up time of 19 months, the study found. Patients with a TAPSE of less than 1.5 cm had especially poor outcomes.
"Our results suggest that TAPSE is a robust measure of right ventricular function and a powerful predictor of patient survival in pulmonary hypertension," Hassoun said.
He and his co-authors recommended that a TAPSE test be incorporated into the echocardiographic assessment of all pulmonary hypertension patients.
The findings were published in the November issue of the American Journal of Respiratory and Critical Care Medicine.
The U.S. National Heart, Lung, and Blood Institute has more about pulmonary hypertension.