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Related Experiment Video

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Assessment of RV-PA Coupling in Advanced Heart Failure Using TAPSE×PAAT and Its Association With Functional Capacity.

Murat Karaçam1, Seda Tanyeri2, Barkın Kültürsay3

  • 1Department of Cardiology, Bitlis State Hospital, Bitlis, Turkey.

Echocardiography (Mount Kisco, N.Y.)
|April 9, 2026
PubMed
Summary
This summary is machine-generated.

The TAPSE×PAAT index is a valuable tool for assessing functional capacity in advanced heart failure (HF). This echocardiographic surrogate of RV-PA coupling offers comparable results to TAPSE/PASP, especially when PASP estimation is challenging.

Keywords:
Peak VO2RV–PA couplingTAPSE/PASPTAPSE×PAATadvanced heart failure

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Area of Science:

  • Cardiology
  • Echocardiography
  • Heart Failure Research

Background:

  • Right ventricular-pulmonary arterial (RV-PA) coupling is crucial for functional capacity in advanced heart failure (HF).
  • The TAPSE/PASP ratio, a common surrogate for RV-PA coupling, has limitations due to tricuspid regurgitation (TR) Doppler signal dependency.
  • Pulmonary artery acceleration time (PAAT) offers a TR-independent measure of pulmonary vascular load, leading to the development of the TAPSE×PAAT index.

Purpose of the Study:

  • To evaluate the efficacy of the TAPSE×PAAT index as a surrogate for RV-PA coupling in advanced HF patients.
  • To compare the performance of TAPSE×PAAT against the traditional TAPSE/PASP ratio in predicting functional capacity.
  • To assess the association between these indices and peak oxygen uptake (peak VO2) as a measure of functional capacity.

Main Methods:

  • A retrospective study of 194 advanced HF patients with comprehensive echocardiography, cardiopulmonary exercise testing, and right heart catheterization.
  • Patients were stratified into tertiles based on TAPSE×PAAT values.
  • Multivariable regression models, including LASSO variable selection, were used to analyze associations between RV-PA coupling indices and peak VO2. Model performance was compared using adjusted R², AIC, and RMSE.

Main Results:

  • Higher TAPSE×PAAT values correlated with improved exercise performance, showing a stepwise increase in peak VO2 across tertiles (p < 0.001).
  • Both TAPSE/PASP and TAPSE×PAAT were independently associated with peak VO2 in multivariable analyses.
  • While TAPSE/PASP showed slightly better global fit statistics, TAPSE×PAAT demonstrated consistent statistical significance and high agreement in predicted peak VO2 values.

Conclusions:

  • The TAPSE×PAAT index demonstrates a comparable relationship with functional capacity in advanced HF patients as the TAPSE/PASP ratio.
  • TAPSE×PAAT serves as a valuable complementary echocardiographic surrogate for RV-PA coupling.
  • This index is particularly useful in clinical scenarios where accurate pulmonary artery systolic pressure (PASP) estimation is difficult.