The TAPSE/PASP ratio and MELD score in patients with advanced heart failure

医学 心脏病学 内科学 心力衰竭 中心静脉压 预加载 反流(循环) 缺血性心肌病 血压 射血分数 血流动力学 心率
作者
Rezzan Deniz Acar,Şencan Acar,Cem Doğan,Zübeyde Bayram,Ahmet Karaduman,Samet Uysal,Özgür Yaşar Akbal,Aykun Hakgör,Ci̇hangi̇r Kaymaz,Nihal Özdemir
出处
期刊:Herz [Springer Science+Business Media]
卷期号:46 (S1): 75-81 被引量:5
标识
DOI:10.1007/s00059-019-04879-x
摘要

The aim of this study was to explore the relationship between the tricuspid annular plane systolic excursion/pulmonary arterial systolic pressure (TAPSE/PASP) ratio and model for end-stage liver disease (MELD) score in patients with advanced heart failure. A total of 103 patients with advanced heart failure evaluated for candidacy for heart transplantation were included in this study. TAPSE was measured by M‑mode echocardiography and cardiac catheterization was performed. TAPSE/ PASP ratio and MELD score were calculated. The median age of patients was 49 (40.5–54) years and the majority were male (92%). The percentage of patients with ischemic cardiomyopathy was 40%. The mean value of the groupʼs MELD score was 10 ± 3.3 and the median value of TAPSE/PASP 0.24 (0.18–0.34). There was a moderate negative correlation between TAPSE/PASP and MELD score (r: −0.38, p < 0.001). Right atrial pressure (RAP) and left ventricular end-diastolic pressure (LVEDP) were also negatively correlated with TAPSE/PASP (correlation coefficients were r: −0.562 and r: −0.575, respectively). In patients with a lower TAPSE/PASP ratio, MELD score, LVEDP and RAP were higher and tricuspid regurgitation was more severe, but there were no significant differences between cardiac output (CO) and mean aortic pressure (mean BP). The presence of ischemia was found to be an independent predictor for lower values of TAPSE/PASP. The lower TAPSE/PASP obtained on echocardiography may be a sign of the multi-organ failure defined as a high MELD score in patients with advanced heart failure.
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