Related Experiment Video
Updated: Jan 18, 2026
Induction of Right Ventricular Failure by Pulmonary Artery Constriction and Evaluation of Right Ventricular Function in Mice
Published on: May 13, 2019
Preoperative Right Ventricle-to-Pulmonary Artery Coupling Correlates With Intensive Care Length of Stay After
Mads Dam Lyhne1, Mark Stoltenberg Ellegaard1, Kasper Krohn Korsholm2
1Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Department of Anesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark.
Objectives:
To investigate whether preoperative noninvasive measurement of right ventricle-to-pulmonary artery coupling, assessed by the tricuspid annular plane systolic excursion-to-pulmonary artery systolic pressure (TAPSE:PASP) ratio, is associated with perioperative outcomes following pulmonary endarterectomy (PEA).
Design:
Retrospective, single-center cohort study.
Settings:
Tertiary university hospital: national center for chronic thromboembolic pulmonary hypertension (CTEPH) treatment.
Participants:
Patients with CTEPH eligible for PEA.
Interventions:
Patients underwent transthoracic echocardiography and right heart catheterization before undergoing PEA. The TAPSE:PASP ratio was calculated from preoperative echocardiography and dichotomized at 0.17 mm/mmHg.
Measurements And Main Results:
The primary outcome was intensive care unit (ICU) length of stay (LOS). Secondary outcomes included vasoactive and inotropic therapy, representing perioperative hemodynamic instability. Sixty patients were included. The median TAPSE:PASP ratio was 0.20 mm/mmHg (interquartile range [IQR], 0.15-0.29 mm/mmHg); 38% of patients had ratios below 0.17 mm/mmHg. A lower TAPSE:PASP ratio was associated with higher N-terminal pro-brain natriuretic peptide levels and pulmonary vascular resistance, as well as greater right ventricular dilatation. The median ICU LOS was longer in patients with a TAPSE:PASP ratio below 0.17 mm/mmHg (96 hours [IQR, 60-218 hours] v 63 hours [IQR, 41-93 hours], p = 0.0044), with an odds ratio (OR) of 3.45 (95% confidence interval [CI], 1.16-11.11) for ICU LOS greater than 72 hours. Patients with lower TAPSE:PASP ratios had a higher (OR, 3.33; 95% CI, 1.11-10.00; p = 0.032) and prolonged (OR, 3.70; 95% CI, 1.23-11.11; p = 0.019) need for vasoactive and inotropic therapy.
Conclusions:
A lower preoperative TAPSE:PASP ratio was associated with prolonged ICU stay and hemodynamic compromise after PEA. The TAPSE:PASP ratio may serve as a valuable, noninvasive tool for preoperative risk stratification in patients with CTEPH undergoing surgical treatment.
Related Concept Videos
01:21Cardiac Catheterization II: Right Heart Catheterization
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management