The value of right ventricular pulmonary artery coupling in determining the prognosis of patients with sepsis

Sci Rep. 2024 Jul 3;14(1):15283. doi: 10.1038/s41598-024-65738-2.

Abstract

The outcomes of patients with sepsis are influenced by the contractile function of the right ventricle (RV), but the impact of cardiopulmonary interaction in ICU-mortality of sepsis patients remains unclear. This study aims to investigate the ICU-mortality impact of right ventricular-pulmonary artery (RV-PA) coupling in patients with sepsis. We employed echocardiography to assess patients with sepsis within the initial 24 h of their admission to the ICU. RV-PA coupling was evaluated using the tricuspid annular plane systolic excursion (TAPSE) to pulmonary artery systolic pressure (PASP) ratio. A total of 92 subjects were enrolled, with 55 survivors and 37 non-survivors. TAPSE/PASP ratio assessed mortality with an area under the curve (AUC) of 0.766 (95% CI 0.670-0.862) and the optimal cutoff value was 0.495 mm/mmHg. We constructed a nomogram depicting the TAPSE/PASP in conjunction with IL-6 and Lac for the joint prediction of sepsis prognosis, and demonstrated the highest predictive capability (AUC = 0.878, 95% CI 0.809-0.948). In conclusion, the TAPSE/PASP ratio demonstrated prognostic value for ICU mortality in sepsis patients. The nomogram, which combines the TAPSE/PASP, IL-6, and LAC, demonstrated enhanced predictive efficacy for the prognosis of sepsis patients.

Keywords: Cardiopulmonary coupling; Echocardiography; Hemodynamics; Sepsis.

MeSH terms

  • Aged
  • Echocardiography*
  • Female
  • Heart Ventricles* / diagnostic imaging
  • Heart Ventricles* / physiopathology
  • Hospital Mortality
  • Humans
  • Intensive Care Units
  • Male
  • Middle Aged
  • Prognosis
  • Pulmonary Artery* / diagnostic imaging
  • Pulmonary Artery* / physiopathology
  • Sepsis* / diagnosis
  • Sepsis* / mortality
  • Sepsis* / physiopathology
  • Ventricular Function, Right / physiology