The prognostic role of tricuspid annular plane systolic excursion in critically ill patients with septic shock

Abstract

INTRODUCTION: The right ventricle (RV) may play a crucial role in predicting prognosis in critical settings. The value of the tricuspid annular plane systolic excursion (TAPSE) has been shown in the prognosis of cardiac patients, such as those with heart failure and pulmonary hypertension. The aim of this study was to evaluate the possible prognostic performance of RV dysfunction, as assessed by the TAPSE, in noncardiac septic shock patients. METHODOLOGY: One hundred critically ill adult patients diagnosed with septic shock were enrolled directly after admission. The TAPSE was measured within 24 h. Patients were analyzed according to 28-day mortality and divided into non-survivors and survivors. RESULTS: The overall 28-day mortality rate was 62%. TAPSE showed a strong negative correlation with APACHE-II (r = - 0.569, p < 0.001) and moderately negatively correlated with the SOFA score (r = - 0.448, p = 0.001). TAPSE (at a cutoff point of 2 cm) was a very good tool (area under curve = 0.887) for predicting 28-day mortality (95% confidence interval CI 0.770-0.980, p < 0.0001). CONCLUSION: Early echocardiographic assessment of RV dysfunction to measure TAPSE might be of prognostic importance in noncardiac patients with septic shock, as a TAPSE less than 2 cm was useful for predicting poor outcomes. TRIAL REGISTRATION: clinicaltrials.gov, NCT06008067. Registered 18 July 2023 registered. TAPSESEPTIC study.