三尖瓣环平面收缩期位移在感染性休克重症患者中的预后作用。

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

作者信息

Habib Tamer, Ahmed Islam, Abayazeed Rasha, Montasser Mina

机构信息

Critical Care Medicine Department, Faculty of Medicine, Alexandria University, Alexandria, 21111, Egypt.

Public Health and Community Medicine Department, Faculty of Medicine, Suez-Canal University, Ismailia, Egypt.

出版信息

J Anesth Analg Crit Care. 2025 Apr 30;5(1):24. doi: 10.1186/s44158-025-00227-0.

DOI:10.1186/s44158-025-00227-0

PMID:40307938

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12042442/

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.

摘要

引言

右心室（RV）在预测危急情况下的预后可能起着关键作用。三尖瓣环平面收缩期位移（TAPSE）的价值已在心脏病患者（如心力衰竭和肺动脉高压患者）的预后中得到体现。本研究的目的是评估通过TAPSE评估的右心室功能障碍在非心源性感染性休克患者中的可能预后价值。

方法

100例确诊为感染性休克的成年危重症患者在入院后直接入组。在24小时内测量TAPSE。根据28天死亡率对患者进行分析，并分为非幸存者和幸存者。

结果

总体28天死亡率为62%。TAPSE与急性生理与慢性健康状况评分系统II（APACHE-II）呈强负相关（r = -0.569，p < 0.001），与序贯器官衰竭评估（SOFA）评分呈中度负相关（r = -0.448，p = 0.001）。TAPSE（截断点为2 cm）是预测28天死亡率的非常好的工具（曲线下面积 = 0.887）（95%置信区间CI 0.770 - 0.980，p < 0.0001）。