Predicting Survival Rates in Pulmonary Hypertension

A new study reports a simple, noninvasive way to measure right ventricular function in the heart to predict survival of adults who suffer from pulmonary hypertension (PH).

Researchers at Johns Hopkins Hospital (Baltimore, MD, USA) studied 63 consecutive patients with PH. Study participants were mostly female, white, and were an average age of 55. After right-heart catheterization, these patients underwent a transthoracic echocardiogram to assess right ventricular performance in the heart. The researchers performed a test called tricuspid annular plane systolic excursion (TAPSE), which measures echocardiographic abnormalities in the tricuspid valve.

The researchers found that a TAPSE of less than 1.8 cm was associated with a greater ventricular systolic dysfunction, as well as right-heart remodeling. Survival estimates at one and two years for those with pulmonary arterial hypertension (PAH) were 94% and 88%, respectively, for individuals with a TAPSE of 1.8 cm or greater. Patients with a TAPSE of less than 1.8 cm, showing more advanced right ventricular dysfunction, had dramatically reduced survival rates of 60% at one year and 50% at two years. Patients with a TAPSE of less than 1.5 cm had an especially poor outcome. The study appeared in the November 1, 2006, edition of the American Journal of Respiratory and Critical Care Medicine.

"Our results suggest that TAPSE is a robust measure of right-ventricular function and a powerful predictor of patient survival in pulmonary hypertension,” said lead author Dr. Paul M. Hassoun, M.D., of the divisions of cardiology, pulmonary, and critical care medicine at Johns Hopkins Hospital, who added that the researchers believed the TAPSE test should be incorporated into the echocardiographic assessment of all patients with PAH.



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