Department of Nephrology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research, Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, People's Republic of China.
Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular disease, Department of Cardiology, Tianjin Institute of Cardiology, the Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China.
Ren Fail. 2024 Dec;46(2):2413872. doi: 10.1080/0886022X.2024.2413872. Epub 2024 Oct 11.
Tricuspid annular plane systolic excursion (TAPSE)/pulmonary artery systolic pressure (PASP) as a noninvasively measured index of right ventricular-pulmonary artery uncoupling is associated with poor outcomes in heart failure patients. However, the relationship by which the TAPSE/PASP is linked to atrial fibrillation (AF) in peritoneal dialysis (PD) patients is not clear. We aimed to investigate the relationship between the TAPSE/PASP and AF in PD patients.
This study was divided into two parts. First, we included 329 PD patients. All the subjects provided detailed a medical history, laboratory analysis and transthoracic echocardiography on admission. We evaluated the differences in the TASPE/PASP ratios between the AF and non-AF groups. Second, a total of 121 patients were followed up to compare mortality between the AF and non-AF groups.
Age, BNP, RDW, LA, and septal E/e' were significantly higher, and TAPSE/PASP was significantly lower in patients with AF than in those without AF ( < 0.05). Moreover, the TAPSE/PASP was more pronounced in persistent AF patients. PD patients with AF had a greater risk of mortality (7.2%) than did those without AF (3.8%) after an average follow-up of 12 months. Kaplan-Meier analysis revealed that patients with TAPSE/PASP ratios ≤ 0.715 had a greater risk of mortality than did those with TAPSE/PASP ratios > 0.715.
The results suggested that the TAPSE/PASP was lower in AF patients than in non-AF patients. The TAPSE/PASP may be a useful factor for predicting mortality in AF patients with PD, but large-scale prospective studies are needed for verification.
三尖瓣环平面收缩期位移（TAPSE）/肺动脉收缩压（PASP）作为右心室-肺动脉解耦的非侵入性测量指标，与心力衰竭患者的不良预后相关。然而，TAPSE/PASP 与腹膜透析（PD）患者心房颤动（AF）之间的关系尚不清楚。我们旨在研究 PD 患者 TAPSE/PASP 与 AF 之间的关系。
本研究分为两部分。首先，我们纳入了 329 名 PD 患者。所有患者入院时均提供详细的病史、实验室分析和经胸超声心动图。我们评估了 AF 组和非 AF 组之间 TAPSE/PASP 比值的差异。其次，共对 121 例患者进行随访，比较 AF 组和非 AF 组的死亡率。
年龄、BNP、RDW、LA 和间隔 E/e'在 AF 患者中明显高于非 AF 患者，TAPSE/PASP明显低于非 AF 患者（<0.05）。此外，持续性 AF 患者的 TAPSE/PASP 更为明显。PD 患者中，AF 患者的死亡率（7.2%）高于非 AF 患者（3.8%），平均随访 12 个月后。Kaplan-Meier 分析显示，TAPSE/PASP 比值≤0.715 的患者死亡率高于 TAPSE/PASP 比值>0.715 的患者。
结果表明，AF 患者的 TAPSE/PASP 低于非 AF 患者。TAPSE/PASP 可能是预测 PD 合并 AF 患者死亡率的有用因素，但需要大规模前瞻性研究加以验证。
