In-hospital prognostic value of TAPSE/sPAP in patients hospitalized for acute heart failure
Author:
Fauvel Charles1ORCID, Dillinger Jean-Guillaume2, Rossanaly Vasram Reza3, Bouleti Claire4, Logeart Damien2, Roubille François5, Meune Christophe6ORCID, Ohlmann Patrick7, Bonnefoy-Coudraz Eric8, Albert Franck9, Attou Sabir10, Boukhris Marouane11, Pommier Thibaut12, Merat Benoit13, Noirclerc Nathalie14, Bouali Nabil15, Aghezzaf Samy16ORCID, Schurtz Guillaume16, Mansencal Nicolas17ORCID, Andrieu Stéphane18, Henry Patrick2, Pezel Théo2, , Aboyans Victor, Albert Emeric, Albert Franck, Alvain Sean, Amri Nabil, Andrieu Stéphane, Attou Sabir, Auvray Simon, Azzakani Sonia, Azencot Ruben, Bedossa Marc, Boccara Franck, Boccara Albert, Bochaton Thomas, Bonnefoy-Cudraz Eric, Bonnet Guillaume, Bonnet Guillaume, Bouali Nabil, Bouchot Océane, Bouleti Claire, Boukertouta Tanissia, Brette Jean Baptiste, Canu Marjorie, Chaib Aures, Charbonnel Clement, Chaussade Anne Solene, Coppens Alexandre, Cottin Yves, Darmon Arthur, De Angelis Elena, Delmas Clément, Delsarte Laura, Deney Antoine, Dib Jean Claude, Dillinger Jean-Guillaume, Docq Clemence, Dupasquier Valentin, Elbaz Meyer, El Hadad Antony, El Ouahidi Amine, Ezzouhairi Nacim, Fabre Julien, Fard Damien, Fauvel Charles, Gerbaud Édouard, Gilard Martine, Goralski Marc, Grinberg Nissim, Grentzinger Alain, Hauguel-Moreau Marie, Henry Patrick, Huet Fabien, Landemaine Thomas, Lattuca Benoit, Lemarchand Léo, Levasseur Thomas, Lim Pascal, Maitre Ballesteros Laura, Mansencal Nicolas, Marie Benjamin, Martinez David, Merat Benoit, Meune Christophe, Millischer Damien, Moine Thomas, Nhan Pascal, Noirclerc Nathalie, Ohlmann Patrick, Pezel Théo, Picard Fabien, Piliero Nicolas, Pommier Thibaut, Puymirat Etienne, Ramonatxo Arthur, Rossanaly Vasram Reza, Roubille François, Roule Vincent, Schurtz Guillaume, Stevenard Mathilde, Sulman David, Swedsky Fédérico, Tea Victoria, Thevenet Eugénie, Thuaire Christophe, Trimaille Antonin, Tron Christophe, Viboud Guillaume, Yomi Dominique, Zakine Cyril
Affiliation:
1. Department of Cardiology, CHU Rouen, Inserm U1096, Univ Rouen Normandie , 1 rue de Germont, F-76000 Rouen , France 2. Inserm U-942, Assistance Publique-Hôpitaux de Paris, Hôpital Lariboisière, Department of Cardiology, Université de Paris Cité , 2 rue Ambroise Paré, 75010 Paris , France 3. Department of Cardiology, Felix-Guyon University Hospital , 11021 All. Des Topazes, Saint-Denis-de-la-Réunion , France 4. Cardiology Department, Clinical Investigation Center (INSERM 1204), University Hospital of Poitiers , 2 Rue de la Milétrie, 86000 Poitiers , France 5. Department of Cardiology, CHU Montpellier , 191 Av. du Doyen Gaston Giraud, 34295 Montpellier , France 6. Department of Cardiology, Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris , 125 Rue de Stalingrad, 93000 Bobigny , France 7. Department of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital , 1 place de l'Hôpital, Strasbourg , France 8. Intensive Cardiological Care Division, Louis Pradel Hospital, Hospices Civils de Lyon , 59 Bd Pinel, Bron , France 9. Service de Cardiologie, Centre Hospitalier de Chartres , 4 rue Claude Bernard, 28360 Le Coudray , France 10. Department of Cardiology, Caen University Hospital , Av. de la Côte de Nacre,14000 Caen , France 11. Department of Cardiology, Limoges University Hospital , 2 Av. Martin Luther King, 87000 Limoges , France 12. Department of Cardiology, Dijon University Hospital , 2 boulevard Mar de Lattre de Tassigny, 21000 Dijon , France 13. Service de cardiologie et médecine aéronautique, Hôpital d'Instruction des Armées Percy , 101 avenue Henri Barbusse, 92140 Clamart , France 14. Service de Cardiologie, Centre hospitalier Annecy Genevois , 1 Avenue de l'Hôpital, 74370 Epagny Metz-Tessy , France 15. Service de Cardiologie, Centre hospitalier de Saintonge , 11, boulevard Ambroise-Paré, 17100 Saintes , France 16. Department of Cardiology, University Hospital of Lille , Bd du Professeur Jules Leclercq, 59000 Lille , France 17. Service de Cardiologie, Boulogne Billancourt, Hôpital Ambroise Pare, University Hospital Center , 9 Av. Charles de Gaulle, 92100 Boulogne-Billancourt , France 18. Service de Cardiologie, Hôpital Henri Duffaut , 305A Rue Raoul Follereau, 84000 Avignon , France
Abstract
Abstract
Aims
Tricuspid annular plane systolic excursion over systolic pulmonary artery pressure (TAPSE/sPAP) assessed by echocardiography appears to be a good non-invasive approach for right ventricular to pulmonary artery coupling assessment. We aimed to assess the in-hospital prognostic value of TAPSE/sPAP among patients hospitalized for acute heart failure (AHF).
Methods and results
In total, 333 consecutive patients (mean age 68 ± 14 years, 70% of male, mean left ventricular ejection fraction 44 ± 16%) were hospitalized for AHF across 39 French cardiology departments, with TAPSE/sPAP measured by echocardiography within the first 24 h of hospitalization were included in this prospective study. The primary outcome was in-hospital major adverse cardiovascular events (MACEs) defined as all-cause death, resuscitated cardiac arrest or cardiogenic shock and occurred in 50 (15%) patients. Using receiver operating characteristic curve analysis, the best TAPSE/sPAP threshold for in-hospital MACEs was 0.40 mm/mmHg. TAPSE/sPAP < 0.40 mm/mmHg was independently associated with in-hospital MACEs, even after adjustment with comorbidities [odds ratio (OR): 3.75, 95% CI (1.87–7.93), P < 0.001], clinical severity [OR: 2.80, 95% CI (1.36–5.95), P = 0.006]. Using a 1:1 propensity-matched population, TAPSE/sPAP ratio < 0.40 was associated with a higher rate of in-hospital MACEs [OR: 2.98, 95% CI (1.53–6.12), P = 0.002]. After adjustment, TAPSE/sPAP < 0.40 showed the best improvement in model discrimination and reclassification above traditional prognostic factors (C-statistic improvement: 0.05; χ2 improvement: 14.4; likelihood-ratio test P < 0.001). These results were consistent in an external validation cohort of 133 patients.
Conclusion
TAPSE/sPAP < 0.40 mm/mmHg assessed by an early echocardiography during an AHF episode is independently associated with in-hospital MACEs suggesting enhanced close monitoring and strengthened heart failure-specific care in these patients.
Trial Registration
ClinicalTrials.gov Identifier: NCT05063097
Funder
Fondation Coeur et Recherche
Publisher
Oxford University Press (OUP)
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