Valor predictivo positivo de la relación TAPSE/PSAP EN ecocardiografía comparado con manometria mediante cateterismo cardíaco derecho para el diagnóstico de hipertensión pulmonar arterial: un estudio retrospectivo Unicéntrico en el Hospital Alcívar durante el periodo de enero 2018 a junio 2023.

Abstract

Introduction: Pulmonary arterial hypertension (PAH) is characterized by a mean pulmonary arterial pressure greater than 20 mmHg. Right heart catheterization (RHC) is the standard for its diagnosis, but Doppler echocardiography and TAPSE/PSAP ratio, which assesses right ventricle-pulmonary artery coupling, are also explored as screening methods. This study aims to compare the efficacy of TAPSE/PSAP with CCD in the diagnosis of PAH at Hospital Alcívar. Methodology: The study is observational, longitudinal, retrospective and analytical, using data from medical records of Hospital Alcívar between 2018 and 2023. Patients with pulmonary hypertension were analyzed using echocardiography and cardiac catheterization. Diagnostic validation tests were performed for the TAPSE/PSAP ratio, in addition to ROC curve, linear and logistic regression. Data were managed in Microsoft Excel and SPSS. Results: 2531 medical records of patients with unstable angina and right heart catheterization between 2018 and 2023 were reviewed. 2396 records were excluded, leaving 125 patients. Of these, 70 had PAH and 55 did not. The TAPSE/PSAP ratio showed a sensitivity of 78.57% and specificity of 45.45%, with an area under the ROC curve of 0.74. Linear and logistic regression confirmed that TAPSE/PSAP is predictive for PAH. Conclusions: In conclusion, TAPSE/PSAP is useful for PAH screening, with a sensitivity of 78.57%, specificity of 45.45% and accuracy of 64%. The positive predictive value was 64.7% and the negative predictive value was 62.5%. Although these results are lower than those reported in the literature, they can optimize time and costs with trained personnel.