Abstract
Although the echocardiographic:derived ratio of tricuspid annular plane systolic excursion (TAPSE) to pulmonary arterial systolic pressure (PASP) is an important prognostic tool in heart failure (HF), the relation with 6-minute walk distance (6MWD) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) is less established. We sought to establish the normative values of TAPSE:PASP among older adults without cardiovascular disease (CVD) and evaluate the relation with NT-proBNP and 6MWD. Among 1,542 participants of the Multi-Ethnic Study of Atherosclerosis-HF ancillary study, the cross-sectional association of TAPSE:PASP with the outcomes of 6MWD and NT-proBNP was analyzed using multivariable linear regression, with progressive adjustment for sociodemographic and CVD risk factors. Our cohort had a mean age (SD) of 73 ± 8 years, 55% women, and a mean TAPSE:PASP ratio of 0.68 ± 0.16. In the unadjusted analysis, increasing tertiles of TAPSE:PASP were associated with younger age, less diabetes, higher estimated glomerular filtration rate, and less antihypertensive medication use. The TAPSE:PASP ratio significantly correlated with both 6MWD and NT-proBNP in the fully adjusted models. A 1-unit increment in TAPSE:PASP was associated with an adjusted 9.9% (4.8% to 15.2%) higher 6MWD, whereas a 1-unit increment in TAPSE:PASP was associated with an adjusted 38.0% (16.0% to 54.2%) lower NT-proBNP. There was a significant gender interaction of the association of TAPSE:PASP ratio and 6MWD, with stronger association seen in women. Among multiethnic older adults free of clinical CVD, the TAPSE:PASP ratio decreased with age, especially in women and was associated with decreased 6MWD and increasing NT-proBNP, the markers of subclinical HF.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 41-51 |
| Number of pages | 11 |
| Journal | American Journal of Cardiology |
| Volume | 196 |
| DOIs | |
| State | Published - Jun 1 2023 |
Funding
Dr. Mukherjee is funded by the National Scleroderma Foundation and National Institutes of Health/National Heart, Lung, and Blood Institute, Bethesda, Maryland , R01HL162851 . Dr. Michos is supported by the Amato Fund for Women's Cardiovascular Health at Johns Hopkins, Baltimore, Maryland, and American Heart Association, Dallas, Texas, grant 946222. Dr. Hays is supported by National Institutes of Health/National Heart, Lung, and Blood Institute, Bethesda, Maryland, R01HL147660. Dr. Shah is supported by National Institutes of Health /National Heart, Lung, and Blood Institute, Bethesda, Maryland ( R01HL107577 , R01HL127028 , R01HL140731 , and R01HL149423 ); the American Heart Association , Dallas, Texas (No. 16SFRN28780016 ); Actelion, Allschwil, Switzerland; Corvia, Tewksbury, Massachusetts; Novartis (Basel, Switzerland), AstraZeneca, Cambridge, United Kingdom; and Pfizer, New York, New York. The MESA study is supported by contracts: 75N92020D00001 , HHSN268201500003I , N01-HC-95159 , 75N92020D00005 , N01-HC-95160 , 75N92020D00002 , N01-HC-95161 , 75N92020D00003 , N01-HC-95162 , 75N92020D00006 , N01-HC-95163 , 75N92020D00004 , N01-HC-95164 , 75N92020D00007 , N01-HC-95165 , N01-HC-95166 , N01-HC-95167 , N01-HC95168 , and N01-HC-95169 from the National Heart, Lung, and Blood Institute, Bethesda, Maryland, and by grants UL1-TR-000040, UL1-TR-001079, and UL1-TR-001420 from the National Center for Advancing Translational Sciences , Bethesda, Maryland. Ancillary studies were funded by grants R01-HL127028 , R01-HL086719 , R01-HL077612 , R01-HL075476 , and R01-HL098433 .
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
