In systemic sclerosis, the TAPSE/sPAP ratio can be used in addition to the DETECT algorithm for pulmonary arterial hypertension diagnosis.


Journal

Rheumatology (Oxford, England)
ISSN: 1462-0332
Titre abrégé: Rheumatology (Oxford)
Pays: England
ID NLM: 100883501

Informations de publication

Date de publication:
30 05 2022
Historique:
received: 15 07 2021
revised: 23 09 2021
pubmed: 5 10 2021
medline: 3 6 2022
entrez: 4 10 2021
Statut: ppublish

Résumé

Early detection of pulmonary arterial hypertension (PAH) is crucial for improving patient outcomes. The aim of this study was to compare the positive predictive value (PPV) of the echocardiography-derived tricuspid annular plane systolic excursion/systolic pulmonary artery pressure (TAPSE/sPAP) ratio with that of the DETECT algorithm for PAH screening in a cohort of SSc patients. Fifty-one SSc patients were screened for PAH using the DETECT algorithm and echocardiography. Echocardiography was recommended by the DETECT algorithm step 1 in 34 patients (66.7%). Right heart catheterization (RHC) was recommended by the DETECT algorithm step 2 in 16 patients (31.4%). PAH was confirmed by RHC in 5 patients. The DETECT algorithm PPV was 31.3%. The TAPSE/sPAP ratio was higher in SSc patients not referred for RHC than in SSc patients referred for RHC according to the DETECT algorithm step 2 [0.83 (0.35-1.40) mm/mmHg vs 0.74 (0.12-1.09)  mm/mmHg, P < 0.05]. Using a cut-off of 0.60 mm/mmHg, 8 (15.7%) SSc patients had a TAPSE/sPAP ratio of ≤0.60 mm/mmHg. PAH was confirmed by RHC in 5 patients. The PPV of TAPSE/sPAP was 62.5%. In multiple regression analysis, TAPSE/sPAP was associated with age [β coefficient = -0.348 (95% CI: -0.011, -0.003); P < 0.01], DETECT algorithm step 1 [β coefficient = 1.023 (95% CI: 0.006, 0.024); P < 0.01] and DETECT algorithm step 2 (β coefficient = -1.758 [95% CI: -0.059, -0.021]; P < 0.0001). In SSc patients with a DETECT algorithm step 2 total score of >35, the TAPSE/sPAP ratio can be used to further select patients requiring RHC to confirm PAH diagnosis.

Identifiants

pubmed: 34605890
pii: 6380960
doi: 10.1093/rheumatology/keab748
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

2450-2456

Informations de copyright

© The Author(s) 2021. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Auteurs

Amalia Colalillo (A)

Department of Translational and Precision Medicine, Sapienza University.

Maria Chiara Grimaldi (MC)

Division of Cardiology, Sant'Andrea Hospital, Rome, Italy.

Valentina Vaiarello (V)

Department of Translational and Precision Medicine, Sapienza University.

Chiara Pellicano (C)

Department of Translational and Precision Medicine, Sapienza University.

Giorgia Leodori (G)

Department of Translational and Precision Medicine, Sapienza University.

Antonietta Gigante (A)

Department of Translational and Precision Medicine, Sapienza University.

Antonella Romaniello (A)

Division of Cardiology, Sant'Andrea Hospital, Rome, Italy.

Edoardo Rosato (E)

Department of Translational and Precision Medicine, Sapienza University.

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