The Value Of TAPSE/PASP And NT-proBNP In Assessing Right Heart Function In Patients With Pulmonary Hypertension

Objectives:Studying patients with congenital heart disease,chronic thromboembolic pulmonary hypertension,we discussed the relation between the ratio of tricuspid annular systolic displacement to pulmonary systolic blood pressure(TAPSE/PASP),plasma N-terminal brain natriuretic peptide precursor(NT-proBNP)and the hemodynamic parameters measured by right heart catheterization,the relationship between TAPSE/PASP and NTproBNP.To analyze the relationship between TAPSE/PASP、NT-proBNP and pulmonary arterial systolic pressure(PASP)with echocardiogram estimation,and whether there was a difference between TAPSE/PASP and NT-proBNP in different degrees of pulmonary hypertension,and to explore the value of TAPSE/PASP and NT-proBNP in the evaluation of right heart function in patients with pulmonary hypertension.Methods:A total of 65 patients with PAH caused by congenital heart disease and pulmonary embolism in our hospital were collected,and all patients underwent echocardiography to measure the systolic displacement of the tricuspid annular systolic displacement(TAPSE),estimate the pulmonary arterial systolic pressure(PASP),and calculate TAPSE/PASP;Blood was drawn to test plasma NT-proBNP values,and right heart catheterization was performed on the same day to record right ventricular hemodynamic parameters,including mean pulmonary arterial pressure(m PAP),pulmonary vascular resistance(PVR),and systolic pulmonary arterial pressure.s PAP),diastolic blood pressure(d PAP),cardiac index(CI),cardiac output(CO).According to the PASP estimated by echocardiography,patients with PAH were divided into three groups,mild PAH group,moderate PAH group and severe PAH group.The relationship between TAPSE/PASP,NT-proBNP and right ventricular hemodynamic parameters,Afterwards,we discussed respectively the relationship between TAPSE/PASP,NT-proBNP and PASP,and analyzed the differences between three groups,assessed the distinction between TAPSE/PASP and NT-proBNP in patients with three groups of pulmonary hypertension varying degrees.Results:1.TAPSE/PASP showed a negative correlation trend with mean pulmonary artery pressure(mPAP),pulmonary vascular resistance(PVR),pulmonary systolic blood pressure(sPAP),diastolic blood pressure(dPAP)(P<0.05),and positive correlation with cardiac index(CI)and cardiac output(CO)(P<0.05).2.NT-proBNP was positively correlated with mPAP,sPAP,dPAP,PVR(P<0.05)and CI and CO(P<0.05).3.TAPSE/PASP is negatively correlated with PASP,and NT-proBNP is positively correlated with PASP.4.TAPSE/PASP values in moderate PAH group and severe PAH group were remarkably lower than those in mild PAH group,TAPSE/PASP values in severe PAH group were significantly lower than those in moderate PAH group,TAPSE/PASP decreased with the increase of pulmonary artery pressure,and the differences were statistically meaningful(P<0.05),The NT-proBNP values in the moderate PAH group and the severe PAH group were remarkably higher than those in the mild group,the NTproBNP values in the severe PAH group were dramatically higher than those in the moderate PAH group,and the differences make sense statistically(P<0.05).Conclusions:1.TAPSE/PASP and NT-proBNP are both related to the hemodynamic parameters measured by the right heart catheterization,and TAPSE/PASP and NT-proBNP can replace invasive examinations to assess the patient’s right heart function.2.TAPSE/PASP is negatively correlated with PASP and NT-proBNP is positively correlated with PASP.3.There was a statistically significant discrepancy between TAPSE/PASP and NTproBNP in different degrees of pulmonary hypertension,and with the pulmonary artery pressure increasing,TAPSE/PASP gradually decreased,and NT-proBNP increased little by little.4.TAPSE/PASP and NT-proBNP are negatively correlated,and the combined application of TAPSE/PASP and NT-proBNP complements each other,and the evaluation of right heart function in patients with pulmonary hypertension is of greater significance than the evaluation of single parameters,which provides a favorable basis for the early diagnosis of right heart function impairment in patients.