Echocardiographic TAPSE, sPAP and TAPSE/sPAP thresholds linked to mortality in HF

Abstract-only findings from a transthoracic echocardiography analysis link RV function and pulmonary pressure measures to nonlinear increases in all-cause mortality.

Measures included tricuspid annular plane systolic excursion (TAPSE), systolic pulmonary artery pressure (sPAP), and the TAPSE/sPAP ratio (an index of RV–pulmonary artery coupling) across multiple clinical and reference cohorts. The populations described span patients with HFrEF and HFpEF, as well as asymptomatic subjects with cardiovascular risk factors and healthy controls. Within that scope, the abstract centers on mortality-associated cutoffs for sPAP, TAPSE, and TAPSE/sPAP, and on which echo-derived measure appeared most robust for outcome prediction.

The abstract reports that TAPSE and sPAP were obtained in four cohorts: 1,660 patients with HFrEF, 718 with HFpEF, 210 subjects with cardiovascular risk factors, and 216 healthy controls. It further states that Cox proportional hazards regression was used to assess associations between sPAP, TAPSE, and the TAPSE/sPAP ratio with mortality, framing the analysis as time-to-event rather than cross-sectional comparisons. Overall, the setup is presented as an observational assessment of how these echocardiographic measures relate to all-cause mortality across distinct participant categories.

In the results summarized in the abstract, mortality at follow-up increased nonlinearly as sPAP rose and as TAPSE or the TAPSE/sPAP ratio fell. The abstract provides prespecified cutoffs at which risk was described as increasing: 33 mmHg for sPAP, 19 mm for TAPSE, and 0.68 mm/mmHg for TAPSE/sPAP. Presented this way, the thresholds serve as landmarks for points at which the association with mortality was observed to shift in a nonlinear fashion. Across all three cutpoints, the same overall pattern is described: higher pulmonary pressures and lower RV functional measures (including the coupling ratio) aligned with increasing mortality.

Beyond thresholds, the abstract reports comparative prognostic performance, noting that the TAPSE/sPAP ratio predicted outcome more robustly than either component alone, as assessed by different metrics (without detailing the specific metrics in the abstract). It also states that results were essentially the same across heart failure etiologies or categories and among subjects with cardiovascular risk factors, indicating consistency of the reported associations across these groups.

One exception is specified: TAPSE alone did not have a significant impact on outcome in HFpEF. As framed in the abstract, these comparisons position the coupling ratio as the measure most consistently associated with outcomes relative to systolic pulmonary artery pressure (sPAP) or TAPSE considered individually.

Summary of Abstract Findings:

• The abstract reports nonlinear increases in all-cause mortality with higher pulmonary pressure estimates and lower RV systolic function measures, including the RV–PA coupling ratio.
• The abstract reported cut-off values for sPAP (33 mmHg), TAPSE (19 mm), and TAPSE/sPAP (0.68 mm/mmHg), with mortality risk described as increasing nonlinearly beyond these thresholds.
• The abstract reports more robust outcome prediction by the TAPSE/sPAP ratio than by either component alone, with broadly similar findings across heart failure categories and cardiovascular risk-factor cohorts except for TAPSE-alone performance in HFpEF.