The importance of RV – PA coupling in the 1-year follow-up of patients living at high altitude and initiating treatment with a diagnosis of pulmonary hypertension

Introduction and Purpose: Pulmonary hypertension (PH) is an important health problem that is characterized by an increase in mean pulmonary artery pressure (PAP), has a high risk of mortality, and can affect all age groups. Our study aimed to evaluate patients living in the Eastern Anatolia region and followed in our clinic using noninvasive RA-PV coupling. Materials and Methods: 100 Group I and Group IV patients who were diagnosed with PH and followed up at Van YYÜ Dursun Odabaş Medical Center between January 2020 and April 2024 were evaluated retrospectively. Patients' ages, demographic data, gender, height and weight measurements, comorbidities, smoking status, World Health Organization Functional Capacity (WHO-FC) classification, transthoracic echocardiography (TTE) findings, 6-minute walk test (6MWT), blood values. The treatments they received, survival times, and risk situations during diagnosis and follow-up were recorded. Findings: 86 (86.0%) of the patients were female, 14 (14.0%) were male, the average age was 49.04±17.09 years. 81 (81.0%) of the patients were Group I, 19 patients (19.0%) are in Group IV. The average survival time of the patients was 50.19±153.60 days and 12 of them (12.0%) died. TAPSE/sPAP values of ex patients were found to be statistically significantly lower than alive patients (p<0.05). In ROC curve analysis, the TAPSE/sPAP ratio at the first visit predicted mortality with a cutoff value of 0.20 mm/mmHg, 66.7% sensitivity and 71.3% specificity. Discussion and Conclusion: In our study, we evaluated whether the TAPSE/sPAP ratio is a prognostic parameter in patients living at high altitudes. In the study, it was found that the TAPSE/sPAP ratio at the first visit was effective in predicting mortality. The TAPSE/sPAP ratio has shown a strong correlation with risk stratification during follow-ups, and taking this ratio into account plays an important role in the management of PH patients.