Amalia Colalillo, Chiara Pellicano, Lidia P. Ananyeva, Eric Hachulla, Giovanna Cuomo, Andrea-Hermina Györfi, László Czirják, Jeska de Vries-Bouwstra, Luc Mouthon, Hadi Poormoghim, Francesco Del Galdo, Nicolas Hunzelmann, Julia Spierings, Masataka Kuwana, Edoardo Rosato, and the EUSTAR Collaborators
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Logistic regression and Cox regression analysis were performed to evaluate TAPSE/sPAP as a risk factor for chronic kidney disease (CKD) and overall survival.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 2,370 patients with SSc were included; 284 (12%) patients had CKD stage 3a–5. TAPSE/sPAP (odds ratio [OR] 0.479; 95% CI 0.310–0.743; <i>P</i> < 0.001), arterial hypertension (OR 3.118; 95% CI 2.173–4.475; <i>P</i> < 0.001), diastolic dysfunction (OR 1.670; 95% CI 1.148–2.428; <i>P</i> < 0.01), and N-terminal pro-B-type natriuretic peptide (OR 1.165; 95% CI 1.041–1.304; <i>P</i> < 0.01) were associated with CKD stage 3a–5. TAPSE/sPAP ≤0.32 mm/mm Hg (hazard ratio [HR] 3.589; 95% CI 2.236–5.761; <i>P</i> < 0.001), eGFR <60 mL/min per 1.73 m<sup>2</sup> (HR 2.818; 95% CI 1.777–4.468; <i>P</i> < 0.001), and age (HR 1.782; 95% CI 1.348–2.356; <i>P</i> < 0.001) were the most significant predictive factors for all-cause mortality. A total of 276 patients with SSc had pulmonary hypertension (PH) confirmed by right-sided heart catheterization, with 69 (25%) having CKD stage 3a–5. No difference was found in eGFR between patients with PH with reduced or normal cardiac index.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>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 m<sup>2</sup> are prognostic factors for all-cause mortality. In patients with SSc with PH, eGFR is independent by reduced cardiac output.</p>\n </section>\n </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"77 2","pages":"257-265"},"PeriodicalIF":3.7000,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771623/pdf/","citationCount":"0","resultStr":"{\"title\":\"Tricuspid Annular Plane Systolic Excursion/Systolic Pulmonary Artery Pressure Ratio and Cardiorenal Syndrome Type 2 in the Systemic Sclerosis EUSTAR Cohort\",\"authors\":\"Amalia Colalillo, Chiara Pellicano, Lidia P. 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引用次数: 0
摘要
目的:本研究的目的是评估欧洲硬皮病试验与研究(EUSTAR)队列中三尖瓣环平面收缩漂移(TAPSE)/收缩期肺动脉压(sPAP)比和估计肾小球滤过率(eGFR)之间的关系及其与死亡率的关系。方法:纳入EUSTAR数据库中具有TAPSE、sPAP和计算eGFR所需参数的系统性硬化症(SSc)患者。采用Logistic回归和Cox回归分析来评估TAPSE/sPAP作为慢性肾脏疾病(CKD)和总生存的危险因素。结果:共纳入2370例SSc患者;284例(12%)患者为CKD 3a-5期。TAPSE/sPAP(优势比[OR] 0.479;95% ci 0.310-0.743;p2 (hr 2.818;95% ci 1.777-4.468;结论:TAPSE/sPAP比值降低与CKD独立相关。TAPSE/sPAP比值≤0.32 mm/mm Hg和eGFR 2是全因死亡的预后因素。在伴有PH的SSc患者中,eGFR与心输出量减少无关。
Tricuspid Annular Plane Systolic Excursion/Systolic Pulmonary Artery Pressure Ratio and Cardiorenal Syndrome Type 2 in the Systemic Sclerosis EUSTAR Cohort
Objective
The aim of the study was to evaluate the association between the tricuspid annular plane systolic excursion (TAPSE)/systolic pulmonary artery pressure (sPAP) ratio and estimated glomerular filtration rate (eGFR) and their association with mortality in the European Scleroderma Trials and Research (EUSTAR) cohort.
Methods
Patients with systemic sclerosis (SSc) from the EUSTAR database with TAPSE, sPAP, and parameters required to calculate eGFR were included. Logistic regression and Cox regression analysis were performed to evaluate TAPSE/sPAP as a risk factor for chronic kidney disease (CKD) and overall survival.
Results
A total of 2,370 patients with SSc were included; 284 (12%) patients had CKD stage 3a–5. TAPSE/sPAP (odds ratio [OR] 0.479; 95% CI 0.310–0.743; P < 0.001), arterial hypertension (OR 3.118; 95% CI 2.173–4.475; P < 0.001), diastolic dysfunction (OR 1.670; 95% CI 1.148–2.428; P < 0.01), and N-terminal pro-B-type natriuretic peptide (OR 1.165; 95% CI 1.041–1.304; P < 0.01) were associated with CKD stage 3a–5. TAPSE/sPAP ≤0.32 mm/mm Hg (hazard ratio [HR] 3.589; 95% CI 2.236–5.761; P < 0.001), eGFR <60 mL/min per 1.73 m2 (HR 2.818; 95% CI 1.777–4.468; P < 0.001), and age (HR 1.782; 95% CI 1.348–2.356; P < 0.001) were the most significant predictive factors for all-cause mortality. A total of 276 patients with SSc had pulmonary hypertension (PH) confirmed by right-sided heart catheterization, with 69 (25%) having CKD stage 3a–5. No difference was found in eGFR between patients with PH with reduced or normal cardiac index.
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.
期刊介绍:
Arthritis Care & Research, an official journal of the American College of Rheumatology and the Association of Rheumatology Health Professionals (a division of the College), is a peer-reviewed publication that publishes original research, review articles, and editorials that promote excellence in the clinical practice of rheumatology. Relevant to the care of individuals with rheumatic diseases, major topics are evidence-based practice studies, clinical problems, practice guidelines, educational, social, and public health issues, health economics, health care policy, and future trends in rheumatology practice.