Prognostic Value of Tricuspid Annular Plane Systolic Excursion and Right Ventricular Outflow Tract Fractional Shortening in Mechanically Ventilated Septic Patients.
J Cardiothorac Vasc Anesth
; 2020 Oct 08.
Article
in English
| MEDLINE | ID: covidwho-1292184
ABSTRACT
OBJECTIVE:
The authors aimed to explore whether tricuspid annular plane systolic excursion (TAPSE) and right ventricular outflow fractional shortening (RVOT-FS) were associated with long-term prognosis in mechanically ventilated septic patients.DESIGN:
A prospective observational study.SETTING:
A tertiary hospital intensive care unit (ICU).PARTICIPANTS:
One hundred eighty-one septic patients who were on mechanical ventilation.INTERVENTIONS:
Echocardiography was performed within 24 hours of ICU admission. MEASUREMENTS AND MAINRESULTS:
Several echocardiographic parameters, including TAPSE and RVOT-FS, as well as prognostic information, were collected. A Cox regression survival analysis showed that TAPSE was independently associated with one-year all-cause mortality (hazard ratio [HR] 0.407, 95% confidence interval [CI] 0.200-0.827, pâ¯=â¯0.013), but ROVT-FS was not (HR 0.997, 95% CI 0.970-1.025, pâ¯=â¯0.828). ROC analysis showed that the optimal cutoff value for TAPSE and RVOT-FS to determine one-year mortality was TAPSE <18 mm and RVOT-FS <40%. The one-year mortality in patients with low TAPSE (nâ¯=â¯88) and in patients with both low TAPSE and low RVOT-FS (nâ¯=â¯60) was 45.5% and 48.3%, respectively; pâ¯=â¯0.724. In a multivariate analysis, RVOT-FS did not add significant prognostic information to that provided by TAPSE <18 mm (pâ¯=â¯0.197).CONCLUSIONS:
TAPSE was an independent predictor of one-year all-cause mortality in mechanically ventilated septic patients. RVOT-FS was not associated with one-year mortality and added no prognostic value to TAPSE in these patients.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Type of study:
Observational study
/
Prognostic study
Language:
English
Journal subject:
Anesthesiology
/
Cardiology
Year:
2020
Document Type:
Article
Affiliation country:
J.jvca.2020.10.002
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