Prediction of repeat pulmonary balloon angioplasty within using TAPSE/sPAP ratio in chronic thromboembolic pulmonary hypertension
10.3760/cma.j.cn112434-20250309-00073
- VernacularTitle:TAPSE/sPAP比值预测毛细血管前肺动脉高压患者再行肺动脉球囊成形术的价值
- Author:
Dezhi REN
1
;
Jiajun XIONG
;
Chenchen LYU
;
Yaqi XU
;
Zhenguo ZHAI
;
Wanmu XIE
;
Hui WANG
;
Jun DUAN
Author Information
1. 中日友好医院（中日友好临床医学研究所） 北京协和医学院 中国医学科学院，北京 100029
- Publication Type:Journal Article
- Keywords:
Echocardiography;
Precapillary pulmonary hypertension;
Balloon pulmonary angioplasty;
TAPSE/sPAP ratio
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2025;41(9):544-549
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the predictive value of the tricuspid annular plane systolic excursion to systolic pulmonary artery pressure ratio(TAPSE/sPAP) in identifying precapillary pulmonary hypertension(pcPH) patients requiring repeat balloon pulmonary angioplasty(BPA) within 3 months after initial intervention, and to determine independent risk factors associated with postoperative reintervention.Methods:We retrospectively collected clinical data from 215 consecutive patients with pcPH undergoing BPA. After applying exclusion criteria, 200 patients were ultimately included in the analysis. The predictive value of the TAPSE/sPAP for short-term BPA reintervention was assessed using receiver operating characteristic( ROC) curve analysis and multivariable logistic regression. Internal validation was performed through bootstrap resampling with 1 000 iterations to evaluate model stability. Results:A risk model for echocardiography was constructed using multiple logistic regression, and the results showed that systolic pulmonary artery pressure(sPAP), peak tricuspid regurgitation velocity(TRV), tricuspid regurgitation pressure gradient(PGTR), and TAPSE/sPAP ratio were predictive factors for BPA surgery in patients with pulmonary hypertension within 3 months. Multivariate regression analysis suggests that the TAPSE/sPAP ratio is an independent influencing factor for BPA after 3 months( OR=0.023, P<0.05). The predicted area under the ROC curve( AUC) for BPA after 3 months is 0.62(95% CI: 0.530-0.648), P<0.01, which is better than other cardiac ultrasound indicators. At the same time, internal bootstrap method was used for internal self-validation, and the AUC of the internal self-validation set was 0.67. Conclusion:The TAPSE/sPAP ratio serves as an independent predictor for requiring repeat BPA within 3 months postoperatively in patients with pcPH.
