{
  "abstract": "The ratio of tricuspid annular plane systolic excursion to systolic pulmonary artery pressure (TAPSE/sPAP) is a noninvasive surrogate of right ventricular-pulmonary arterial coupling, but its value for dynamic risk stratification in chronic thromboembolic pulmonary hypertension (CTEPH) remains uncertain. This multicenter prospective cohort enrolled adults with CTEPH between 2016 and 2023. Patients were stratified by quartile-based baseline TAPSE/sPAP cutoffs into < 0.15, 0.15 to 0.30, and > 0.30. The primary outcome was clinical worsening (CW) within 12 months, comprising all-cause death, hospitalization for worsening pulmonary hypertension, escalation of pulmonary hypertension-targeted therapy, or a > 30% increase in pulmonary vascular resistance. Associations were examined using Kaplan-Meier, Cox regression, and time-dependent Cox analyses. Among 949 patients, 868 had follow-up and 212 (24.4%) experienced CW during a median follow-up of 10.3 months (interquartile range, 5.4-12.2 months). Lower baseline TAPSE/sPAP was associated with worse functional and hemodynamic profiles, and CW-free survival differed across strata (log-rank p = 0.004). Each 0.1-unit increase in baseline TAPSE/sPAP was associated with lower CW risk (adjusted HR, 0.89; 95% CI, 0.79-0.99; p = 0.039). Among 593 patients with serial measurements, higher time-updated TAPSE/sPAP (adjusted HR, 0.66; 95% CI, 0.52-0.83; p < 0.001) and greater improvement from baseline (adjusted HR, 0.81; 95% CI, 0.71-0.92; p = 0.002) were associated with lower subsequent CW risk. Lower TAPSE/sPAP identifies greater disease severity and CW risk in CTEPH. Serial TAPSE/sPAP may support noninvasive dynamic risk stratification and residual risk assessment during follow-up.",
  "abstract_shown": true,
  "affiliations": [
    "China-Japan Friendship Hospital Chinese Academy of Medical Sciences & Peking Union Medical College Beijing China.",
    "National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine China-Japan Friendship Hospital Beijing China.",
    "Department of Pulmonary and Critical Care Medicine, Beijing Chaoyang Hospital Capital Medical University Beijing China.",
    "Department of Pulmonary Circulation, Shanghai Pulmonary Hospital Tongji University School of Medicine Shanghai China.",
    "Department of Respiratory and Critical Care Medicine Shandong Provincial Hospital Affiliated to Shandong First Medical University Jinan Shandong China.",
    "Department of Pulmonary and Critical Care Medicine, State Key Laboratory of Respiratory Diseases, Guangdong Key Laboratory of Vascular Diseases, Guangzhou Institute of Respiratory Health The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Guangdong China.",
    "Department of Cardiology Tianjin Medical University General Hospital Tianjin China.",
    "Department of Pulmonary and Critical Care Medicine, Beijing Anzhen Hospital Capital Medical University Beijing China.",
    "Department of Geriatric Medicine Qilu Hospital of Shandong University Jinan Shandong China.",
    "Department of Pulmonary and Critical Care Medicine The First Affiliated Hospital of Chongqing Medical University Chongqing China.",
    "Department of Pulmonary and Critical Care Medicine, East Hospital Tongji University School of Medicine Shanghai China.",
    "Department of Pulmonary and Critical Care Medicine Affiliated Hospital of Jianghan University Wuhan Hubei China.",
    "Department of Pulmonary and Critical Care Medicine The Affiliated Hospital of Qingdao University Qingdao Shandong China.",
    "Department of Pulmonary and Critical Care Medicine The First People's Hospital of Yunnan Province Kunming Yunnan China.",
    "State Key Laboratory of Cardiovascular Disease, Department of Pulmonary Vascular Disease, National Center for Cardiovascular Disease, Fuwai Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China.",
    "Department of Cardiology Qilu Hospital of Shandong University Jinan Shandong China.",
    "Department of Cardiovascular Surgery China-Japan Friendship Hospital Beijing China.",
    "Department of Radiology China-Japan Friendship Hospital Beijing China.",
    "Department of Cardiology China-Japan Friendship Hospital Beijing China.",
    "Department of Nuclear Medicine China-Japan Friendship Hospital Beijing China.",
    "National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine China-Japan Friendship Hospital Beijing China.",
    "Chinese Academy of Medical Sciences Peking Union Medical College Beijing China.",
    "Department of Respiratory Medicine Capital Medical University Beijing China.",
    "WHO Collaboration Center for Tobacco Cessation and Respiratory Diseases Prevention Beijing China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 32,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Jing Wen"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Ruzetuoheti Yiminniyaze"
    },
    {
      "affs": [
        2
      ],
      "name": "Yishan Li"
    },
    {
      "affs": [
        3
      ],
      "name": "Sugang Gong",
      "orcid": "0000-0002-6583-5119"
    },
    {
      "affs": [
        4
      ],
      "name": "Ling Zhu",
      "orcid": "0000-0002-4765-4058"
    },
    {
      "affs": [
        2
      ],
      "name": "Yuanhua Yang",
      "orcid": "0000-0003-0293-6737"
    },
    {
      "affs": [
        5
      ],
      "name": "Cheng Hong",
      "orcid": "0000-0002-0710-8757"
    },
    {
      "affs": [
        6
      ],
      "name": "Zhenwen Yang"
    },
    {
      "affs": [
        7
      ],
      "name": "Jun Wan"
    },
    {
      "affs": [
        8
      ],
      "name": "Xiaopei Cui",
      "orcid": "0000-0002-9724-6175"
    },
    {
      "affs": [
        9
      ],
      "name": "Hong Chen"
    },
    {
      "affs": [
        10
      ],
      "name": "Yingqun Ji"
    },
    {
      "affs": [
        11
      ],
      "name": "Chenghong Li"
    },
    {
      "affs": [
        12
      ],
      "name": "Zhaozhong Cheng"
    },
    {
      "affs": [
        13
      ],
      "name": "Yunhui Zhang",
      "orcid": "0000-0003-4545-2863"
    },
    {
      "affs": [
        14
      ],
      "name": "Changming Xiong",
      "orcid": "0000-0001-7468-5039"
    },
    {
      "affs": [
        3
      ],
      "name": "Lan Wang"
    },
    {
      "affs": [
        15
      ],
      "name": "Qiushang Ji",
      "orcid": "0000-0002-4532-7096"
    },
    {
      "affs": [
        11
      ],
      "name": "Fajiu Li",
      "orcid": "0009-0009-9594-5157"
    },
    {
      "affs": [
        1
      ],
      "name": "Zhu Zhang",
      "orcid": "0000-0002-7602-096X"
    },
    {
      "affs": [
        1
      ],
      "name": "Yunxia Zhang"
    },
    {
      "affs": [
        1
      ],
      "name": "Qiang Huang",
      "orcid": "0000-0002-5949-1225"
    },
    {
      "affs": [
        16
      ],
      "name": "Yanan Zhen"
    },
    {
      "affs": [
        17
      ],
      "name": "Min Liu",
      "orcid": "0000-0003-1298-4441"
    },
    {
      "affs": [
        18
      ],
      "name": "Lei Li"
    },
    {
      "affs": [
        18
      ],
      "name": "Yanan Zhai",
      "orcid": "0000-0002-5080-9591"
    },
    {
      "affs": [
        18
      ],
      "name": "Aili Li"
    },
    {
      "affs": [
        19
      ],
      "name": "Liping Fu",
      "orcid": "0000-0003-1091-233X"
    },
    {
      "affs": [
        1
      ],
      "name": "Shuai Zhang",
      "orcid": "0000-0003-3247-5847"
    },
    {
      "name": "Wanmu Xie",
      "orcid": "0000-0002-6686-3517"
    },
    {
      "affs": [
        1
      ],
      "name": "Zhenguo Zhai",
      "orcid": "0000-0002-7096-8792"
    },
    {
      "affs": [
        20,
        21,
        22,
        23
      ],
      "name": "Chen Wang"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/ep5e6e3d615t1.bib",
  "cited_by": 0,
  "doi": "10.1002/pul2.70429",
  "fulltext_url": "https://europepmc.org/articles/PMC13686357",
  "id": "ep5e6e3d615t1",
  "issns": [
    "2045-8932",
    "2045-8940"
  ],
  "landing_url": "https://europepmc.org/article/MED/42910319",
  "language": "eng",
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2740|Pulmonary Hypertension Research and Treatments"
    ]
  ],
  "openalex": "W7223084029",
  "pdf_url": "https://europepmc.org/articles/PMC13686357?pdf=render",
  "pmcid": "PMC13686357",
  "pmid": "42910319",
  "published": "2026-10-21",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/ep5e6e3d615t1.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:10Z",
      "native_id": "MED:42910319",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42910319"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2740|Pulmonary Hypertension Research and Treatments",
      "subfield": "general"
    }
  ],
  "title": "Right Ventricular-Pulmonary Arterial Coupling by Serial TAPSE/sPAP: A Noninvasive Predictor for Clinical Outcomes in Chronic Thromboembolic Pulmonary Hypertension.",
  "title_text": "Right Ventricular-Pulmonary Arterial Coupling by Serial TAPSE/sPAP: A Noninvasive Predictor for Clinical Outcomes in Chronic Thromboembolic Pulmonary Hypertension.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:10Z",
  "url": "https://research.draconitic.com/paper/ep5e6e3d615t1",
  "venue": "Pulmonary circulation",
  "versions": []
}