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

Autor:	de Pinto M; Scleroderma Unit, Rheumatology Unit, Azienda Ospedaliero-Universitaria Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy., Coppi F; Cardiology Unit, Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena, Italy.; Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy., Spinella A; Scleroderma Unit, Rheumatology Unit, Azienda Ospedaliero-Universitaria Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy., Pagnoni G; Cardiology Unit, Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena, Italy., Morgante V; Cardiology Unit, Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena, Italy., Macripò P; Scleroderma Unit, Rheumatology Unit, Azienda Ospedaliero-Universitaria Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy., Boschini M; Department of Engineering, University of Modena and Reggio Emilia, Modena, Italy., Guerra AF; Internal Medicine and Centre for Hemochromatosis, University Hospital of Modena, University of Modena and Reggio Emilia, Modena, Italy., Tampieri F; Cardiology Unit, Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena, Italy., Secchi O; Scleroderma Unit, Rheumatology Unit, Azienda Ospedaliero-Universitaria Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy., Orlandi M; Scleroderma Unit, Rheumatology Unit, Azienda Ospedaliero-Universitaria Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy., Amati G; Scleroderma Unit, Rheumatology Unit, Azienda Ospedaliero-Universitaria Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy., Lumetti F; Scleroderma Unit, Rheumatology Unit, Azienda Ospedaliero-Universitaria Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy., Sandri G; Scleroderma Unit, Rheumatology Unit, Azienda Ospedaliero-Universitaria Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy., Rossi R; Cardiology Unit, Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena, Italy.; Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy., Boriani G; Cardiology Unit, Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena, Italy.; Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy., Mattioli AV; Settore Scienze Tecniche e Mediche Applicate Presso Alma Mater Studiorum, Università di Bologna, Bologna, Italy., Ferri C; Scleroderma Unit, Rheumatology Unit, Azienda Ospedaliero-Universitaria Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy.; Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy., Giuggioli D; Scleroderma Unit, Rheumatology Unit, Azienda Ospedaliero-Universitaria Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy.; Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy.
Jazyk:	angličtina
Zdroj:	Frontiers in cardiovascular medicine [Front Cardiovasc Med] 2024 Oct 14; Vol. 11, pp. 1430903. Date of Electronic Publication: 2024 Oct 14 (Print Publication: 2024).
DOI:	10.3389/fcvm.2024.1430903
Abstrakt:	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. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (© 2024 de Pinto, Coppi, Spinella, Pagnoni, Morgante, Macripò, Boschini, Guerra, Tampieri, Secchi, Orlandi, Amati, Lumetti, Sandri, Rossi, Boriani, Mattioli, Ferri and Giuggioli.)
Databáze:	MEDLINE
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