Systemic sclerosis & Raynaud's
Tricuspid Annular Plane Systolic Excursion/Systolic Pulmonary Artery Pressure Ratio and Cardiorenal Syndrome Type 2 in the Systemic Sclerosis European Scleroderma Trials and Research (EUSTAR) Cohort
Authors' conclusion
Reduced TAPSE/sPAP ratio is independently associated with CKD. TAPSE/sPAP ratio ≤0.32 mm/mm Hg and eGFR <60 mL/min per 1.73 m2 are prognostic factors for all-cause mortality. In patients with SSc with PH, eGFR is independent by reduced cardiac output.
Study context
- Population
- Patients with systemic sclerosis (SSc) from the EUSTAR database with tricuspid annular plane systolic excursion (TAPSE), systolic pulmonary artery pressure (sPAP) and parameters to calculate estimated glomerular filtration rate (eGFR)284 (12%) with chronic kidney disease (CKD) stage 3a-5
- Participants
- 2,370 patients
- Outcome
- Association of TAPSE/sPAP ratio with CKD (stage 3a-5) and with all-cause mortality
Methodological detailsEUSTAR database, logistic regression, Cox regression
- EUSTAR database
- Logistic regression
- Cox regression
Main finding
As reported in the abstract
Factors associated with CKD stage 3a-5 (logistic regression)
Odds ratio (95% CI)P value
TAPSE/sPAP
0.479(0.310–0.743)
P < 0.001Arterial hypertension
3.118(2.173–4.475)
P < 0.001Diastolic dysfunction
1.670(1.148–2.428)
P < 0.01N-terminal pro-B-type natriuretic peptide
1.165(1.041–1.304)
P < 0.01Observational data: associations, not effects.
Further findings
Predictors of all-cause mortality
| HR (95% CI) | P value | ||
|---|---|---|---|
| TAPSE/sPAP ≤0.32 mm/mm Hg | 3.589 (2.236–5.761) | P < 0.001 | |
| Age | 1.782 (1.348–2.356) | P < 0.001 | |
| 0.20.5125Hazard ratio (log scale) |
| Outcome | Values | HR (95% CI) | P value | |
|---|---|---|---|---|
| Predictors of all-cause mortalityeGFR <60 mL/min per 1.73 m² | 2.818 (1.777–4.468) | P < 0.001 | ||
| 0.20.5125Hazard ratio (log scale) |
| Outcome | Values |
|---|---|
| CKD stage 3a-5 in SSc with PH confirmed by right-sided heart catheterization (subgroup) | PH 25% |
- CKD stage 3a-5 in SSc with pulmonary hypertension (PH) confirmed by right-sided heart catheterization (subgroup): 276 patients with PH
CKD stage 3a-5 in SSc with PH confirmed by right-sided heart catheterization (subgroup)
- No difference in eGFR between PH patients with reduced or normal cardiac index
Original publication
Tricuspid Annular Plane Systolic Excursion/Systolic Pulmonary Artery Pressure Ratio and Cardiorenal Syndrome Type 2 in the Systemic Sclerosis EUSTAR Cohort. Arthritis Care Res (Hoboken). Published 5 September 2023. doi:10.
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