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Peer-reviewedCC BY-NCPulmonary circulation

Right Ventricular-Pulmonary Arterial Coupling by Serial TAPSE/sPAP: A Noninvasive Predictor for Clinical Outcomes in Chronic Thromboembolic Pulmonary Hypertension.

  • Jing Wen1,2
  • Ruzetuoheti Yiminniyaze1,2
  • Yishan Li3
  • Sugang Gong4
  • Ling Zhu5
  • Yuanhua Yang3
  • Cheng Hong6
  • Zhenwen Yang7
  • Jun Wan8
  • Xiaopei Cui9
  • Hong Chen10
  • Yingqun Ji11
20 more authors
  • Chenghong Li12
  • Zhaozhong Cheng13
  • Yunhui Zhang14
  • Changming Xiong15
  • Lan Wang4
  • Qiushang Ji16
  • Fajiu Li12
  • Zhu Zhang2
  • Yunxia Zhang2
  • Qiang Huang2
  • Yanan Zhen17
  • Min Liu18
  • Lei Li19
  • Yanan Zhai19
  • Aili Li19
  • Liping Fu20
  • Shuai Zhang2
  • Wanmu Xie
  • Zhenguo Zhai2
  • Chen Wang21,22,23,24
24 affiliations
  1. 1China-Japan Friendship Hospital Chinese Academy of Medical Sciences & Peking Union Medical College Beijing China.
  2. 2National 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.
  3. 3Department of Pulmonary and Critical Care Medicine, Beijing Chaoyang Hospital Capital Medical University Beijing China.
  4. 4Department of Pulmonary Circulation, Shanghai Pulmonary Hospital Tongji University School of Medicine Shanghai China.
  5. 5Department of Respiratory and Critical Care Medicine Shandong Provincial Hospital Affiliated to Shandong First Medical University Jinan Shandong China.
  6. 6Department 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.
  7. 7Department of Cardiology Tianjin Medical University General Hospital Tianjin China.
  8. 8Department of Pulmonary and Critical Care Medicine, Beijing Anzhen Hospital Capital Medical University Beijing China.
  9. 9Department of Geriatric Medicine Qilu Hospital of Shandong University Jinan Shandong China.
  10. 10Department of Pulmonary and Critical Care Medicine The First Affiliated Hospital of Chongqing Medical University Chongqing China.
  11. 11Department of Pulmonary and Critical Care Medicine, East Hospital Tongji University School of Medicine Shanghai China.
  12. 12Department of Pulmonary and Critical Care Medicine Affiliated Hospital of Jianghan University Wuhan Hubei China.
  13. 13Department of Pulmonary and Critical Care Medicine The Affiliated Hospital of Qingdao University Qingdao Shandong China.
  14. 14Department of Pulmonary and Critical Care Medicine The First People's Hospital of Yunnan Province Kunming Yunnan China.
  15. 15State 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.
  16. 16Department of Cardiology Qilu Hospital of Shandong University Jinan Shandong China.
  17. 17Department of Cardiovascular Surgery China-Japan Friendship Hospital Beijing China.
  18. 18Department of Radiology China-Japan Friendship Hospital Beijing China.
  19. 19Department of Cardiology China-Japan Friendship Hospital Beijing China.
  20. 20Department of Nuclear Medicine China-Japan Friendship Hospital Beijing China.
  21. 21National 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.
  22. 22Chinese Academy of Medical Sciences Peking Union Medical College Beijing China.
  23. 23Department of Respiratory Medicine Capital Medical University Beijing China.
  24. 24WHO Collaboration Center for Tobacco Cessation and Respiratory Diseases Prevention Beijing China.
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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.

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Cite

BibTeXRIS
BibTeX
@article{wen2026right,
  title = {{Right Ventricular-Pulmonary Arterial Coupling by Serial TAPSE/sPAP: A Noninvasive Predictor for Clinical Outcomes in Chronic Thromboembolic Pulmonary Hypertension.}},
  author = {Jing Wen and Ruzetuoheti Yiminniyaze and Yishan Li and Sugang Gong and Ling Zhu and Yuanhua Yang and Cheng Hong and Zhenwen Yang and Jun Wan and Xiaopei Cui and Hong Chen and Yingqun Ji and Chenghong Li and Zhaozhong Cheng and Yunhui Zhang and Changming Xiong and Lan Wang and Qiushang Ji and Fajiu Li and Zhu Zhang and Yunxia Zhang and Qiang Huang and Yanan Zhen and Min Liu and Lei Li and Yanan Zhai and Aili Li and Liping Fu and Shuai Zhang and Wanmu Xie and Zhenguo Zhai and Chen Wang},
  journal = {Pulmonary circulation},
  year = {2026},
  month = oct,
  doi = {10.1002/pul2.70429},
  url = {https://europepmc.org/article/MED/42910319},
  note = {CC BY-NC},
}
RIS
TY  - JOUR
TI  - Right Ventricular-Pulmonary Arterial Coupling by Serial TAPSE/sPAP: A Noninvasive Predictor for Clinical Outcomes in Chronic Thromboembolic Pulmonary Hypertension.
AU  - Jing Wen
AU  - Ruzetuoheti Yiminniyaze
AU  - Yishan Li
AU  - Sugang Gong
AU  - Ling Zhu
AU  - Yuanhua Yang
AU  - Cheng Hong
AU  - Zhenwen Yang
AU  - Jun Wan
AU  - Xiaopei Cui
AU  - Hong Chen
AU  - Yingqun Ji
AU  - Chenghong Li
AU  - Zhaozhong Cheng
AU  - Yunhui Zhang
AU  - Changming Xiong
AU  - Lan Wang
AU  - Qiushang Ji
AU  - Fajiu Li
AU  - Zhu Zhang
AU  - Yunxia Zhang
AU  - Qiang Huang
AU  - Yanan Zhen
AU  - Min Liu
AU  - Lei Li
AU  - Yanan Zhai
AU  - Aili Li
AU  - Liping Fu
AU  - Shuai Zhang
AU  - Wanmu Xie
AU  - Zhenguo Zhai
AU  - Chen Wang
PY  - 2026
DA  - 2026/10/21
JO  - Pulmonary circulation
DO  - 10.1002/pul2.70429
UR  - https://europepmc.org/article/MED/42910319
AB  - 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.
SN  - 2045-8932
SN  - 2045-8940
ER  -