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The predictive role of the TAPSE/sPAP ratio for cardiovascular events and mortality in systemic sclerosis with pulmonary hypertension

Abstract: Introduction: Reduced TAPSE/sPAP ratio has recently emerged as a predictive parameter risk factor for PH, however its role in SSc has been poorly investigated. The aim of the study was to investigate the prognostic value of the TAPSE/sPAP ratio for the prediction of mortality and cardiovascular events in patients with SSc complicated by PH. A comparison between SSc patients with PAH (SSc-PAH) and those with PH and significant ILD (SSc-PH) was also carried out. Materials and methods: A retrospective single-center study in which all patients having SSc—complicated by PH—referring to the Scleroderma-Unit of the AOU Policlinico of Modena, from October 2013 to October 2023 were evaluated. All SSc patients underwent recurrent clinical examination, routine blood chemistry analysis, functional, instrumental evaluation. Results: 61 SSc patients (F/M 52/9) were enrolled. During the follow-up, 60.1% of patients experienced at least one cardiovascular event and 62% died. The main causes of death were PH (39.4%) and other heart-related events (39.4%). The TAPSE/sPAP ratio was significantly lower in deceased patients compared to survivors (mm/mmHg 0.3?±?0.12SD vs. 0.48?±?0.17SD, p?<?0.001). Compared to the SSc-PAH subgroup, the SSc-PH patients had lower survival rates (55.3?±?31.2 SD months vs. 25?±?19 SD, p?=?0,05). At the multivariate analysis, TAPSE/sPAP ratio <0.32?mm/mmHg, male gender, and the presence of significant ILD were identified as independent predictors of mortality and cardiovascular events. Conclusion: Our work confirmed the predictive role of the TAPSE/sPAP ratio for mortality and cardiovascular events in patients with SSc complicated by PH.


Citation:

DE PINTO, Marco; Coppi, Francesca; Spinella, Amelia; Pagnoni, Gianluca; Morgante, Vernizia; Macripò, Pierluca; Boschini, Matteo; Francesca Guerra, Anna; Tampieri, Francesca; Secchi, Ottavio; Orlandi, Martina; Amati, Gabriele; Lumetti, Federica; Sandri, Gilda; Rossi, Rosario; Boriani, Giuseppe; Mattioli, Anna Vittoria; Ferri, Clodoveo; Giuggioli, Dilia "The predictive role of the TAPSE/sPAP ratio for cardiovascular events and mortality in systemic sclerosis with pulmonary hypertension" FRONTIERS IN CARDIOVASCULAR MEDICINE, pp. 1 -13 , 2024 DOI: 10.3389/fcvm.2024.1430903 

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