Objective To explore which factors influence PASP calculated by echocardigraph through tricuspid regurgitation pressure gradient.
Methods The retrospective study recruited 869 consecutive inpatients of Department of Cardiology in Peking University First Hospital, excluding patients who had acute myocardial infarction, pericardial effusion, congenital heart diseases, acute pulmonary embolism and organic tricuspid diseases. Their admission NYHA classification, N-terminal pro-B-type natriuretic peptide (NT-proBNP), echocardiographic and other clinic data were collected. Pulmonary artery systolic pressure (PASP) was derived from trans-tricuspid regurgitation pressure gradient (TRPG) by echocardigraph. We analysed the correlations between PASP and age, sex, renal function, cardiopulmonary diseases and echocardigraph parameters, using single factor analysis and multivariate linear regression analysis.
Results Among these patients, 658 were found to have TR, with a proportion of 75.7%. PASP was independently correlated to chronic obstructive pulmonary disease (COPD) (B (SE): 2.489 (1.121), p=0.027), chronic pulmonary embolism (B (SE): 9.282 (2.175), p<0.001), aortic stenosis (B (SE): 13.846 (3.545), p<0.001), aortic regurgitation (B (SE): 2.386 (1.091), p=0.029), mitral regurgitation (B (SE): 2.093 (0.934), p=0.025) and hypertension (B (SE): 1.560 (0.677), p=0.022), but not to other cardiovascular diseases such as cardiomyopathy, atrial fibrillation, coronary heart diseases and renal function (p>0.05). PASP had independent correlation with both NYHA classification (B (SE): 3.701 (0.468), p=0.002) and NT-proBNP (B (SE): 2.235 (0.569), p<0.001). PASP was correlated to TR severity positively (B (SE): 5.801 (0.798), p<0.001), but not parallel to it. Age was an important predictor of PASP (B (SE): 0.081 (0.027), 95% CI (0.028 to 0.134), p<0.001), with an average increase in PASP of 0.81 mm Hg per decade.
Conclusions Tricuspid regurgitation is common in cardiac patients. PASP was independently correlated to COPD, chronic pulmonary embolism, left ventricular valve diseases and hypertension, but not to cardiomyopathy, atrial fibrillation, coronary heart diseases and renal function. PASP elevated with the increase of NYHA classification and NT-proBNP. It may play an important role in the evaluation of heart function. PASP should not be substituted by TR severity on the valuation of pulmonary circulation pressure. Age was an important predictor of PASP.
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