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| Format: | Artículo Open Access |
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Wiley
2026
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| Online-Zugang: | https://onlinelibrary.wiley.com/doi/10.1111/echo.70445 |
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| author | Murat Karaçam Seda Tanyeri Barkın Kültürsay Azmican Kaya Halit Eminoğlu Ünal Güler Vedat Çiçek Süleyman Çagan Efe İsmail Balaban Kaan Kırali Rezzan Deniz Acar |
| author_facet | Murat Karaçam Seda Tanyeri Barkın Kültürsay Azmican Kaya Halit Eminoğlu Ünal Güler Vedat Çiçek Süleyman Çagan Efe İsmail Balaban Kaan Kırali Rezzan Deniz Acar Murat Karaçam Seda Tanyeri Barkın Kültürsay Azmican Kaya Halit Eminoğlu Ünal Güler Vedat Çiçek Süleyman Çagan Efe İsmail Balaban Kaan Kırali Rezzan Deniz Acar |
| collection | Wiley Open Access |
| contents | Assessment of RV–PA Coupling in Advanced Heart Failure Using TAPSE×PAAT and Its Association With Functional Capacity Murat Karaçam Seda Tanyeri Barkın Kültürsay Azmican Kaya Halit Eminoğlu Ünal Güler Vedat Çiçek Süleyman Çagan Efe İsmail Balaban Kaan Kırali Rezzan Deniz Acar Echocardiography Abstract Background Right ventricular–pulmonary arterial (RV–PA) coupling plays a central role in determining functional capacity in advanced heart failure (HF). Although the TAPSE/PASP ratio is widely used as a noninvasive surrogate of RV–PA coupling, its applicability may be limited by the availability and quality of tricuspid regurgitation Doppler signals. Pulmonary artery acceleration time (PAAT) is a TR‐independent marker of pulmonary vascular load, and the composite index TAPSE×PAAT has emerged as a potential alternative. Methods This retrospective single‐center study included 194 patients with advanced HF who underwent comprehensive transthoracic echocardiography, cardiopulmonary exercise testing, and right heart catheterization. Patients were stratified according to TAPSE×PAAT tertiles. Associations between RV–PA coupling indices (TAPSE/PASP and TAPSE×PAAT) and functional capacity, assessed by peak oxygen uptake (peak VO 2 ), were evaluated using multivariable regression models after variable selection with LASSO. Model performance was compared using adjusted R 2 , AIC, and RMSE. Results Higher TAPSE×PAAT values were associated with progressively better exercise performance. Peak VO 2 increased stepwise across TAPSE×PAAT tertiles (11.3 ± 3.7 vs. 13.4 ± 3.7 vs. 15.3 ± 3.9 mL/kg/min, p < 0.001). In multivariable analyses, both TAPSE/PASP and TAPSE×PAAT remained independently associated with peak VO 2 . The TAPSE/PASP model demonstrated slightly better global fit statistics (adjusted R 2 = 0.511 vs. 0.500; AIC = 980.8 vs. 985.0; RMSE = 2.66 vs. 2.69), whereas TAPSE×PAAT showed consistent statistical significance across models. Agreement between predicted peak VO 2 values derived from both indices was high. Conclusion In advanced HF, TAPSE×PAAT, and TAPSE/PASP showed comparable relationships with functional capacity, supporting TAPSE×PAAT as a complementary echocardiographic surrogate of RV–PA coupling, particularly in clinical settings where PASP estimation is limited. 10.1111/echo.70445 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| doi_str_mv | 10.1111/echo.70445 |
| format | Artículo Open Access |
| id | wiley_oa_10_1111_echo_70445 |
| institution | Wiley Open Access |
| license_str_mv | http://onlinelibrary.wiley.com/termsAndConditions#vor |
| publishDate | 2026 |
| publisher | Wiley |
| record_format | wiley_oa |
| spellingShingle | Assessment of RV–PA Coupling in Advanced Heart Failure Using TAPSE×PAAT and Its Association With Functional Capacity Murat Karaçam Seda Tanyeri Barkın Kültürsay Azmican Kaya Halit Eminoğlu Ünal Güler Vedat Çiçek Süleyman Çagan Efe İsmail Balaban Kaan Kırali Rezzan Deniz Acar Echocardiography Assessment of RV–PA Coupling in Advanced Heart Failure Using TAPSE×PAAT and Its Association With Functional Capacity Murat Karaçam Seda Tanyeri Barkın Kültürsay Azmican Kaya Halit Eminoğlu Ünal Güler Vedat Çiçek Süleyman Çagan Efe İsmail Balaban Kaan Kırali Rezzan Deniz Acar Echocardiography Abstract Background Right ventricular–pulmonary arterial (RV–PA) coupling plays a central role in determining functional capacity in advanced heart failure (HF). Although the TAPSE/PASP ratio is widely used as a noninvasive surrogate of RV–PA coupling, its applicability may be limited by the availability and quality of tricuspid regurgitation Doppler signals. Pulmonary artery acceleration time (PAAT) is a TR‐independent marker of pulmonary vascular load, and the composite index TAPSE×PAAT has emerged as a potential alternative. Methods This retrospective single‐center study included 194 patients with advanced HF who underwent comprehensive transthoracic echocardiography, cardiopulmonary exercise testing, and right heart catheterization. Patients were stratified according to TAPSE×PAAT tertiles. Associations between RV–PA coupling indices (TAPSE/PASP and TAPSE×PAAT) and functional capacity, assessed by peak oxygen uptake (peak VO 2 ), were evaluated using multivariable regression models after variable selection with LASSO. Model performance was compared using adjusted R 2 , AIC, and RMSE. Results Higher TAPSE×PAAT values were associated with progressively better exercise performance. Peak VO 2 increased stepwise across TAPSE×PAAT tertiles (11.3 ± 3.7 vs. 13.4 ± 3.7 vs. 15.3 ± 3.9 mL/kg/min, p < 0.001). In multivariable analyses, both TAPSE/PASP and TAPSE×PAAT remained independently associated with peak VO 2 . The TAPSE/PASP model demonstrated slightly better global fit statistics (adjusted R 2 = 0.511 vs. 0.500; AIC = 980.8 vs. 985.0; RMSE = 2.66 vs. 2.69), whereas TAPSE×PAAT showed consistent statistical significance across models. Agreement between predicted peak VO 2 values derived from both indices was high. Conclusion In advanced HF, TAPSE×PAAT, and TAPSE/PASP showed comparable relationships with functional capacity, supporting TAPSE×PAAT as a complementary echocardiographic surrogate of RV–PA coupling, particularly in clinical settings where PASP estimation is limited. 10.1111/echo.70445 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| title | Assessment of RV–PA Coupling in Advanced Heart Failure Using TAPSE×PAAT and Its Association With Functional Capacity |
| topic | Echocardiography |
| url | https://onlinelibrary.wiley.com/doi/10.1111/echo.70445 |