Refining the accuracy of right ventricular-pulmonary arterial coupling in patients undergoing transcatheter tricuspid valve treatment

Abstract Background Assessing right-ventricular (RV) function is paramount for risk stratification but remains challenging in patients with TR. RV-pulmonary artery (PA) coupling seems more feasible the assessment of RV function. Methods We assessed RV-PA by ratio TAPSE and PASP at baseline, which was measured both echocardiography (ePASP) invasively using a right-heart catheter (iPASP). also fractional-area change (RVFAC) as transthoracic echocardiography. Participants present study comprised undergoing TTVR from June 2015 to July 2021 University Hospital Bonn. Patients lacking either echocardiographic or invasive measurements were excluded analysis. The outcome defined composite mortality rehospitalization due heart failure within one year after procedure. Results A total 206 included participants an advanced age (78.5±7.1 years), predominantly female (58.3%), high surgery (EuroSCORE II: 7.4±4.8%). Massive/torrential TR observed 100 these patients. With median follow-up duration 201 days (interquartile range 98–424 days), occurred 57 Compared TAPSE/ePASP, TAPSE/iPASP showed better predictability outcome: AUCs 0.582 TAPSE/ePASP increased 0.714 when iPASP applied formula (i.e. TAPSE/iPASP). trend true RVFAC (AUCs: 0.561 RVFAC/ePASP, 0.693 RVFAC/iPASP). There significant correlation between ePASP iPASP, whereas attenuated beyond severe massive/torrential TR) (interaction p = 0.01). In addition, semiquantitative estimation right atrial (RA) pressure not correlated measurement. Conclusion analysis confirms that coupling, TAPSE/PASP, powerful predictor TTVR. even improved if PA formulas. Funding Acknowledgement Type funding sources: None.