AUTHOR=de Pinto Marco , Coppi Francesca , Spinella Amelia , Pagnoni Gianluca , Morgante Vernizia , Macripò Pierluca , Boschini Matteo , Guerra Anna Francesca , Tampieri Francesca , Secchi Ottavio , Orlandi Martina , Amati Gabriele , Lumetti Federica , Sandri Gilda , Rossi Rosario , Boriani Giuseppe , Mattioli Anna Vittoria , Ferri Clodoveo , Giuggioli Dilia 

TITLE=The predictive role of the TAPSE/sPAP ratio for cardiovascular events and mortality in systemic sclerosis with pulmonary hypertension

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=11

YEAR=2024

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2024.1430903

DOI=10.3389/fcvm.2024.1430903

ISSN=2297-055X

ABSTRACT=<sec><title>Introduction</title><p>Reduced TAPSE/sPAP ratio has recently emerged as a predictive parameter risk factor for PH, however its role in SSc has been poorly investigated. The aim of the study was to investigate the prognostic value of the TAPSE/sPAP ratio for the prediction of mortality and cardiovascular events in patients with SSc complicated by PH. A comparison between SSc patients with PAH (SSc-PAH) and those with PH and significant ILD (SSc-PH) was also carried out.</p></sec><sec><title>Materials and methods</title><p>A retrospective single-center study in which all patients having SSc—complicated by PH—referring to the Scleroderma-Unit of the AOU Policlinico of Modena, from October 2013 to October 2023 were evaluated. All SSc patients underwent recurrent clinical examination, routine blood chemistry analysis, functional, instrumental evaluation.</p></sec><sec><title>Results</title><p>61 SSc patients (F/M 52/9) were enrolled. During the follow-up, 60.1% of patients experienced at least one cardiovascular event and 62% died. The main causes of death were PH (39.4%) and other heart-related events (39.4%). The TAPSE/sPAP ratio was significantly lower in deceased patients compared to survivors (mm/mmHg 0.3 ± 0.12SD vs. 0.48 ± 0.17SD, <italic>p</italic> &lt; 0.001). Compared to the SSc-PAH subgroup, the SSc-PH patients had lower survival rates (55.3 ± 31.2 SD months vs. 25 ± 19 SD, <italic>p</italic> = 0,05). At the multivariate analysis, TAPSE/sPAP ratio &lt;0.32 mm/mmHg, male gender, and the presence of significant ILD were identified as independent predictors of mortality and cardiovascular events.</p></sec><sec><title>Conclusion</title><p>Our work confirmed the predictive role of the TAPSE/sPAP ratio for mortality and cardiovascular events in patients with SSc complicated by PH.</p></sec>