Diagnostic accuracy of the TAPSE/PASP ratio for right ventricular dysfunction in pulmonary hypertension

Abstract Introduction Pulmonary hypertension (PH) is a complex and progressive condition characterized by elevated pulmonary arterial pressure, which often leads to right ventricular (RV) dysfunction and poor clinical outcomes. Early and accurate assessment of RV function is essential for the management and prognostication of patients with PH. Among various echocardiographic markers, the ratio of tricuspid annular plane systolic excursion to pulmonary artery systolic pressure (TAPSE/PASP) has emerged as a promising non-invasive measure of RV–pulmonary arterial coupling. Purpose This study aimed to evaluate the diagnostic accuracy of the TAPSE/PASP ratio in identifying RV dysfunction and to compare its performance with other conventional echocardiographic parameters. Methods This was a retrospective study including patients diagnosed with PH, defined as a mean pulmonary artery pressure (mPAP) >20 mmHg on right heart catheterization (RHC), between August 2021 and May 2025. Demographic and echocardiographic data were collected. RV dysfunction was defined as a fractional area change (FAC)