To evaluate the diagnostic and prognostic value of tricuspid annular plane systolic excursion/mitral annular plane systolic excursion in acute cardiogenic pulmonary edema
Hu Ruihua
Shi Chunbo
Cao Zanfeng
Liang Zijing
Abstract：Objective To investigate the value of echocardiographic parameters in differentiating cardiogenic and non-cardiogenic pulmonary edema and their relationship with cardiac function and prognosis.Methods A total of 100 patients with acute pulmonary edema admitted to Foresea Life Insurance Guangzhou General Hospital from April 2021 to January 2024 were included.According to clinical symptoms,biological markers,echocardiography and chest CT features,they were divided into cardiogenic pulmonary edema group(n=56)and non-cardiogenic pulmonary edema group(n=44).Left ventricular ejection fraction(LVEF),mitral annular plane systolic excursion(MAPSE),tricuspid annular plane systolic excursion(TAPSE)and TAPSE/MAPSE ratio were measured by echocardiography.The index changes of patients with cardiogenic pulmonary edema before and after positive pressure mechanical ventilation treatment were analyzed,and the efficacy of ultrasonic parameters in differentiating cardiogenic pulmonary edema and the correlation with prognosis were evaluated.Results LVEF,MAPSE,TAPSE and TAPSE/MAPSE in cardiogenic pulmonary edema group were significantly lower than those in non-cardiogenic pulmonary edema group(P＜0.05).The receiver operating characteristic(ROC)curve showed that TAPSE/MAPSE had the highest identification efficiency(AUC=0.790,the sensitivity of 0.933,the specificity of 0.627,and optimal cutoff value of 1.528).Correlation analysis showed that LVEF was positively correlated with MAPSE,TAPSE,TAPSE/MAPSE(r=0.398,0.425,0.436,all P＜0.001).Patients with TAPSE/MAPSE＜1.528 had significantly longer mechanical ventilation time(d:12.32±4.18 vs.8.54±3.11)and hospital stay(d:15.63±5.79 d vs.11.21±4.09).The 30-day mortality rate(15.38％vs.6.67％)and the incidence of acute kidney injury(23.07％vs.10.00％)were significantly increased(all P＜0.05).Conclusions TAPSE/MAPSE has a high value in differentiating cardiogenic and non-cardiogenic pulmonary edema,and is closely related to cardiac function and prognosis,and can be used as an important indicator for clinical evaluation.
Keywords：Cardiogenic pulmonary edemaTricuspid annular plane systolic excursionMitral annular plane systolic excursionDiagnosisPrognosis
Publication Date：2025-05-10
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 401-406 )