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Background <p>Pulmonary arterial hypertension (PAH) is a life-threatening condition characterized by elevated pulmonary artery pressure and progressive right ventricular dysfunction. The ratio of tricuspid annular plane systolic excursion to systolic pulmonary artery pressure (TAPSE/SPAP) has been proposed as a noninvasive marker integrating right ventricular function and afterload. This study aimed to evaluate the clinical and prognostic relevance of TAPSE/SPAP in patients with PAH.</p> Methods and results <p>This study was a retrospective analysis of 125 patients newly diagnosed with PAH at the Xiangya Second Hospital between 2016 and 2022. The patients were divided into two groups based on the median TAPSE/SPAP ratio: a low TAPSE/SPAP group and a high TAPSE/SPAP group. The primary outcome was survival and follow-up was conducted until December 2023. The results showed that a lower TAPSE/SPAP ratio (&lt; 0.15&#xa0;mm/mmHg) was significantly associated with worse survival outcomes, with a higher mortality rate in the low TAPSE/SPAP group (17/63, 27%) than in the high group (7/62, 11.3%). The low TAPSE/SPAP group also exhibited more severe right ventricular remodeling and worse hemodynamic parameters. A significant inverse correlation was found between TAPSE/SPAP and both World Health Organization functional class and NT-proBNP levels, suggesting its role in noninvasive risk stratification.</p> Conclusion <p>In this single-center retrospective cohort, a lower TAPSE/SPAP ratio was associated with more advanced disease and poorer outcomes in patients with PAH. Rather than serving as an independent prognostic predictor, TAPSE/SPAP may function as a composite, noninvasive marker reflecting right ventricular dysfunction and overall disease severity, and may be useful in clinical risk assessment when interpreted alongside established prognostic parameters.</p>

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Clinical relevance of the TAPSE/SPAP ratio in pulmonary arterial hypertension: a single-center retrospective study

  • 期刊论文

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  • 发表日期：

    2026年2月3日

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  • Wenjie Chen,
  • Xiaoqin Luo,
  • Jun Luo,
  • Jie Song,
  • Haihua Qiu,
  • Jingyuan Chen,
  • Chenying Fan,
  • Jiang Li

摘要

Background

Pulmonary arterial hypertension (PAH) is a life-threatening condition characterized by elevated pulmonary artery pressure and progressive right ventricular dysfunction. The ratio of tricuspid annular plane systolic excursion to systolic pulmonary artery pressure (TAPSE/SPAP) has been proposed as a noninvasive marker integrating right ventricular function and afterload. This study aimed to evaluate the clinical and prognostic relevance of TAPSE/SPAP in patients with PAH.

Methods and results

This study was a retrospective analysis of 125 patients newly diagnosed with PAH at the Xiangya Second Hospital between 2016 and 2022. The patients were divided into two groups based on the median TAPSE/SPAP ratio: a low TAPSE/SPAP group and a high TAPSE/SPAP group. The primary outcome was survival and follow-up was conducted until December 2023. The results showed that a lower TAPSE/SPAP ratio (< 0.15 mm/mmHg) was significantly associated with worse survival outcomes, with a higher mortality rate in the low TAPSE/SPAP group (17/63, 27%) than in the high group (7/62, 11.3%). The low TAPSE/SPAP group also exhibited more severe right ventricular remodeling and worse hemodynamic parameters. A significant inverse correlation was found between TAPSE/SPAP and both World Health Organization functional class and NT-proBNP levels, suggesting its role in noninvasive risk stratification.

Conclusion

In this single-center retrospective cohort, a lower TAPSE/SPAP ratio was associated with more advanced disease and poorer outcomes in patients with PAH. Rather than serving as an independent prognostic predictor, TAPSE/SPAP may function as a composite, noninvasive marker reflecting right ventricular dysfunction and overall disease severity, and may be useful in clinical risk assessment when interpreted alongside established prognostic parameters.