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Updated: Jul 13, 2026
Comprehensive Echocardiographic Assessment of Right Ventricle Function in a Rat Model of Pulmonary Arterial Hypertension
Published on: January 20, 2023
Prognostic Value of Echocardiographic TAPSE/PASP Ratio-Defined RV-PA Uncoupling in Cardiovascular and
Hongwei Li1, Yingyuan Zhang2, Haomiao Wang3
1Department of Cardiology, Guangzhou First People's Hospital, South China University of Technology, Guangzhou, China.
Background:
Right ventricular-pulmonary arterial uncoupling (RV-PAuc), assessed by the tricuspid annular plane systolic excursion-to-pulmonary artery systolic pressure (TAPSE/PASP) ratio, acts importantly to determine outcomes in both cardiovascular diseases (CVDs) and non-CVDs.
Objectives:
This study sought to evaluate the prognostic value of the TAPSE/PASP ratio across diseases, identify RV-PAuc-related risk factors, and explore an optimal cutoff for risk stratification and clinical application.
Methods:
Two independent reviewers selected eligible studies, including 82 cohort studies with 32,482 patients for mortality endpoints and 17 observational studies with 4,615 participants for baseline TAPSE/PASP values for this meta-analysis (PROSPERO, CRD42024579107). Relative risk (RR) was calculated for mortality endpoints, and standard mean differences were used for comparisons.
Results:
RV-PAuc was positively associated with mortality in both CADs and non-CADs (RR: 2.20 [95% CI: 2.02-2.40]; I2 = 81.6%]. Cutoff values ranged from 0.15 to 0.70 across conditions: pulmonary arterial hypertension (0.15-0.33), valvular heart disease (0.27-0.55), heart failure (0.33-0.60), cardiac amyloidosis (0.31-0.47), acute coronary syndrome (0.49-0.55), sepsis (0.39-0.50), COVID-19 (0.50-0.64), and other non-CVDs (0.63-0.70). The association remained significant at the 3 most commonly used cutoffs (0.31, 0.36, and 0.50), with heterogeneity eliminated only at 0.50. Except for body mass index, hypertension, and dyslipidemia, factors such as age (0.43-0.67), estimated glomerular filtration rate (0.31-0.60), atrial fibrillation (0.27-0.60), chronic kidney disease (0.34-0.40), coronary artery disease (0.27-0.37), type 2 diabetes (0.40-0.51), stroke, and chronic obstructive pulmonary disease were associated with RV-PAuc, with observed heterogeneity in TAPSE/PASP cutoff values.
Conclusions:
The TAPSE/PASP ratio is a potential prognostic marker for predicting mortality in CVDs and non-CVDs. Despite heterogeneity, a universal cutoff of ≤0.50 mm/mm Hg enhances its clinical applicability.
