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

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

Qiang Ma #  1 , Caiyun Ding #  2 , Wei Wei  1 , Chencheng Su  1 , Bozheng Li  1 , Zihao Zhou  3 , Cui Chen  3 , Biaohu Liu  1 , Xia Zhang  4 , Jingyi Wu  5
Affiliations

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

Qiang Ma et al. Sci Rep. .

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.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Flow chart.
Figure 2
Figure 2
ROC curves of the nomogram, IL-6, TAPSE/PASP, SOFA, Apache II, LAC.
Figure 3
Figure 3
The Kaplan–Meier curves revealed a significantly higher ICU mortality rate in patients with TAPSE/PASP ≤ 0.495 mm/mmHg (log-rank: 25.92, p < 0.001).
Figure 4
Figure 4
Nomogram established for predicting the ICU mortality of patients with sepsis.
See this image and copyright information in PMC

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