TY - JOUR T1 - Tricuspid Annular Plane Systolic Excursion Is a Robust Outcome Measure in Systemic Sclerosis-associated Pulmonary Arterial Hypertension JF - The Journal of Rheumatology JO - J Rheumatol SP - 2410 LP - 2418 DO - 10.3899/jrheum.110512 VL - 38 IS - 11 AU - STEPHEN C. MATHAI AU - CHRISTOPHER T. SIBLEY AU - PAUL R. FORFIA AU - JAMES O. MUDD AU - MICAH R. FISHER AU - RYAN J. TEDFORD AU - NOAH LECHTZIN AU - DANIELLE BOYCE AU - LAURA K. HUMMERS AU - TRACI HOUSTEN AU - ARI L. ZAIMAN AU - REDA E. GIRGIS AU - PAUL M. HASSOUN Y1 - 2011/11/01 UR - http://www.jrheum.org/content/38/11/2410.abstract N2 - Objective. The tricuspid annular plane systolic excursion (TAPSE) strongly reflects right ventricular (RV) function and predicts survival in idiopathic pulmonary arterial hypertension (PAH). But its role in systemic sclerosis (SSc)-associated PAH has not been established. Our objective was to validate the TAPSE in the assessment of RV function and prediction of survival in SSc-PAH. Methods. Fifty consecutive patients with SSc-PAH who underwent echocardiography with TAPSE measurement within 1 h of clinically indicated right heart catheterization were followed prospectively. The relationship between TAPSE and measures of RV function and measures of survival was assessed. Results. The majority of the cohort were women in New York Heart Association class III/IV with severe PAH (mean cardiac index 2.4 ± 0.8 l/min/m2). RV function was significantly impaired (mean cardiac index 2.1 ± 0.7 vs 2.9 ± 0.8 l/min/m2; p < 0.01) and RV afterload was significantly greater (mean pulmonary vascular resistance 11.1 ± 5.1 vs 5.8 ± 2.5 Wood units; p < 0.01) in subjects with a TAPSE ≤ 1.7 cm. The proportion surviving in the low TAPSE group was significantly lower [0.56 (95% CI 0.37–0.71) and 0.46 (95% CI 0.28–0.62) vs 0.87 (95% CI 0.55–0.96) and 0.79 (95% CI 0.49–0.93), 1- and 2-year survival, respectively]. TAPSE ≤ 1.7 cm conferred a nearly 4-fold increased risk of death (HR 3.81, 95% CI 1.31–11.1, p < 0.01). Conclusion. TAPSE is a robust measure of RV function and strongly predicts survival in patients with PAH-SSc. Future studies are needed to identify the responsiveness of TAPSE to PAH-specific therapy and to assess its diagnostic utility in PAH-SSc. ER -