The Prognostic Value of TAPSE/SPAP Ratio for Adverse Outcomes in Acute Heart Failure

Abstract The ratio of tricuspid annular plane systolic excursion to systolic pulmonary artery pressure (TAPSE/SPAP) help us in determination the right ventricular function. This ratio has prognostic role in chronic heart failure, but its value in acute decompensation still uncertain. Our study evaluated the association between this ratio and short term in hospital adverse outcomes in patients with acute decompensated heart failure (ADHF). We performed a retrospective observational analysis including 78 ADHF patients. Clinical, laboratory, and echocardiographic variables were obtained on admission. The primary composite outcome included in hospital death, intravenous inotrope use, or admission to the cardiac intensive care unit. We applied ROC analysis and logistic regression models to assess the prognostic performance of TAPSE/SPAP. The composite outcome occurred in 44.9% of the study population. Patients who developed adverse events present with lower systolic blood pressure, ejection fraction, and TAPSE/SPAP ratio. The TAPSE/SPAP ratio demonstrated modest discrimination (AUC 0.613). In multivariable analysis, ejection fraction remained the only independent predictor of the composite outcome. Lower TAPSE/SPAP values were associated with unfavorable in hospital outcomes; however, its independent prognostic value was limited when adjusted for other variables.