Right ventricular-pulmonary artery coupling in patients undergoing cardiac resynchronization therapy

Area of Science:

• Cardiology
• Cardiovascular Imaging
• Heart Failure Management

Background:

• Right ventricular-pulmonary artery (RV-PA) coupling is crucial for heart function.
• Tricuspid annular plane systolic excursion (TAPSE) to pulmonary artery systolic pressure (PASP) ratio serves as a non-invasive marker of RV-PA coupling.
• Assessing RV-PA coupling is vital in patients undergoing cardiac resynchronization therapy (CRT).

Purpose of the Study:

• To investigate the association between the TAPSE/PASP ratio and CRT response.
• To determine the prognostic value of the TAPSE/PASP ratio in patients receiving CRT.
• To evaluate the impact of CRT on RV-PA coupling.

Main Methods:

• Retrospective analysis of 229 patients who received CRT between 2016 and 2020.
• Echocardiography was used to assess RV-PA coupling (TAPSE/PASP ratio) at baseline and 1-year follow-up.
• Multivariate Cox regression analysis identified predictors of all-cause death.

Main Results:

• The baseline TAPSE/PASP ratio was not significantly associated with CRT response.
• Patients with a lower baseline TAPSE/PASP ratio exhibited significantly worse survival rates.
• The TAPSE/PASP ratio increased significantly in CRT responders but not in non-responders post-implantation.
• Lower estimated glomerular filtration rate was also associated with increased all-cause death.

Conclusions:

• The baseline TAPSE/PASP ratio does not predict CRT response.
• The TAPSE/PASP ratio is a significant independent predictor of all-cause and cardiovascular mortality in CRT recipients.
• Changes in the TAPSE/PASP ratio after CRT may indicate treatment effectiveness in responders.