• Hongmin Zhang, Xiukai Chen, Hui Lian, Qing Zhang, Xiaoting Wang, Min Zheng, Dawei Liu, and Chinese Critical Ultrasound Study Group.
• Department of Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
• J. Cardiothorac. Vasc. Anesth. 2020 Oct 8.

ObjectiveThe 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.DesignA prospective observational study.SettingA tertiary hospital intensive care unit (ICU).ParticipantsOne hundred eighty-one septic patients who were on mechanical ventilation.InterventionsEchocardiography was performed within 24 hours of ICU admission.Measurements And Main ResultsSeveral 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, p = 0.013), but ROVT-FS was not (HR 0.997, 95% CI: 0.970-1.025, p = 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 (n = 88) and in patients with both low TAPSE and low RVOT-FS (n = 60) was 45.5% and 48.3%, respectively; p = 0.724. In a multivariate analysis, RVOT-FS did not add significant prognostic information to that provided by TAPSE <18 mm (p = 0.197).ConclusionsTAPSE 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.Copyright © 2020. Published by Elsevier Inc.

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