The Anatolian Journal of Cardiology - Peer-reviewed cardiology journal publishing original research, reviews, case reports. Impact Factor 1.5. The Anatolian Journal of Cardiology - Leading international cardiology journal with Impact Factor 1.5. Publishing original research, reviews, and case reports in cardiovascular medicine. Indexed in PubMed, Scopus, and Web of Science.

Background: Right ventricular (RV) adaptation to increased pulmonary afterload is a major determinant of prognosis in pulmonary hypertension (PH), yet comprehensive validation of simple noninvasive markers against invasive hemodynamic parameters remains limited. We investigated whether the tricuspid annular plane systolic excursion to systolic pulmonary artery pressure (TAPSE/sPAP) ratio reflects the clinical, echocardiographic, and invasive hemodynamic spectrum of PH. Methods: We retrospectively analyzed 209 consecutive patients with right heart catheterization‐confirmed PH who underwent comprehensive clinical assessment, transthoracic echocardiography, and invasive hemodynamic evaluation between 2016 and 2024. Patients were stratified into quartiles according to the TAPSE/sPAP ratio, and clinical, laboratory, echocardiographic, and hemodynamic characteristics were compared. Results: The mean age was 58.8 ± 16.5 years, and 61% of patients were female. Lower TAPSE/sPAP ratios were associated with older age, higher NT‐proBNP and serum uric acid levels, and lower estimated glomerular filtration rate (all p < 0.05). Decreasing TAPSE/sPAP ratios were also associated with larger right atrial and right ventricular dimensions, lower TAPSE, and higher tricuspid regurgitation velocity and estimated sPAP (all p < 0.001). Invasive hemodynamic assessment demonstrated progressively higher right ventricular systolic pressure, mean pulmonary artery pressure, and pulmonary vascular resistance (all p < 0.001), whereas mixed venous oxygen saturation increased across quartiles ( p = 0.036). Conclusions: The TAPSE/sPAP ratio is a practical, noninvasive marker that closely reflects right ventricular remodeling and invasive hemodynamic impairment in pulmonary hypertension. Lower TAPSE/sPAP ratios identify patients with more advanced RV–pulmonary arterial uncoupling and may improve bedside hemodynamic risk stratification.

The Anatolian Journal of Cardiology - Peer-reviewed cardiology journal publishing original research, reviews, case reports. Impact Factor 1.5. The Anatolian Journal of Cardiology - Leading international cardiology journal with Impact Factor 1.5. Publishing original research, reviews, and case reports in cardiovascular medicine. Indexed in PubMed, Scopus, and Web of Science.

Background/Objectives: Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of death worldwide. The 2023 American Heart Association PREVENT equations represent a contemporary approach to cardiovascular risk estimation, yet they rely on resting clinical and biochemical parameters. This study aimed to evaluate the association between PREVENT-estimated 10-year cardiovascular risk and treadmill exercise testing (TET)-derived physiological variables. Methods: We conducted a single-center observational study of 391 participants (mean age 42.9 ± 9.0 years, 56.8% male) who underwent symptom-limited treadmill testing. Ten-year cardiovascular risk was estimated using PREVENT for total cardiovascular disease (CVD), ASCVD, and heart failure (HF). Hierarchical multivariable regression was performed using log-transformed PREVENT risk estimates to quantify the incremental association of exercise capacity (METs), hemodynamic markers (double product), autonomic recovery (heart rate recovery), and the ST/HR index beyond demographic (age, sex, BMI) and extended clinical base models incorporating available PREVENT input covariates. Results: Beyond the demographic base model, treadmill parameters were significantly associated with log-transformed PREVENT-CVD risk (ΔR² = 0.026, p < 0.001; Cohen’s f² = 0.154). Double product (standardized β = 0.116), HRR at 1 min (standardized β = −0.081), and maximum METs (standardized β = −0.079) were independently associated with risk estimates. However, when the full set of available PREVENT input covariates was included in the base model, the incremental association was negligible (ΔR² = 0.0004, p = 0.386), indicating substantial overlap between exercise-derived physiology and PREVENT-embedded clinical information. The incremental association was greatest in participants with intermediate (1–5%) and higher (≥5%) estimated risk (ΔR² = 0.052 and 0.246, respectively). Approximately 14% of participants shifted to a different quartile of estimated risk after inclusion of treadmill data. Conclusions: Treadmill-derived physiological parameters are significantly associated with PREVENT-estimated cardiovascular risk, but this association largely reflects shared pathophysiology with PREVENT input variables rather than statistically independent incremental information. Exercise testing may serve as a physiological complement to static risk estimation, particularly in intermediate-risk populations, by providing a dynamic physiological assessment that complements resting clinical measurements. Prospective studies with adjudicated cardiovascular outcomes are needed before clinical implementation.