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

Q: What are the key findings of this study?

In noncardiac patients with septic shock, a tricuspid annular plane systolic excursion (TAPSE) of less than 2 cm strongly predicted 28-day mortality with an area under the curve of 0.887.

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Septic shock (n=100). Intervention: Tricuspid annular plane systolic excursion (TAPSE) measurement. Primary outcome: 28-day mortality (AUC 0.887, 95% CI 0.770-0.980, p=<0.0001).

Q: What does this research mean for the field?

In noncardiac patients with septic shock, a tricuspid annular plane systolic excursion (TAPSE) of less than 2 cm strongly predicts 28-day mortality. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

Tamer Habib; Islam Ahmed; Rasha Abayazeed; Mina Montasser

doi:10.1186/s44158-025-00227-0

April 30, 2025Journal of Anesthesia Analgesia and Critical CareOpen Access

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

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Key result

TAPSE below 2 cm strongly predicts mortality in noncardiac septic shock.

AUC 0.887
95% CI 0.770-0.980
P<0.0001
n=100

Figures

Why the study?

While TAPSE has demonstrated prognostic value in cardiac patients, its prognostic performance for assessing RV dysfunction in noncardiac septic shock patients needed evaluation.

Does early echocardiographic assessment of TAPSE predict 28-day mortality in critically ill adult patients with septic shock?

Study Design

Type

Cohort (n=100)

Multicenter

No

Structured PICO

Does early echocardiographic assessment of TAPSE predict 28-day mortality in critically ill adult patients with septic shock?

P

Population

100 critically ill adult patients (18-64 years old) diagnosed with septic shock (Sepsis-3 definition), median age 55.9, 70% male, admitted to critical care units at Alexandria University Hospitals, Egypt. Excluded: pregnant, trauma, documented coronary heart disease, prior myocardial infarction, myocarditis, thromboembolic pulmonary disease, valvular heart disease, cor pulmonale, arrhythmia, known LVEF < 40%.

I

Intervention

Early echocardiographic assessment of right ventricular dysfunction measuring tricuspid annular plane systolic excursion (TAPSE) within 24 hours of admission.

O

Outcome

28-day all-cause mortalityhard clinical

Main Result

Effect estimate: AUC 0.887 (95% CI 0.770-0.980)

p-value: p=<0.0001

Early echocardiographic measurement of TAPSE < 2 cm is a strong predictor of 28-day mortality in noncardiac patients with septic shock.

Limitations

Small sample size for a mortality study in septic shock patients
Lack of prior power calculation
Monocentric study design
TAPSE was the only parameter of RV systolic function measured
Catecholamine and acidosis levels were not measured
Administration of vasopressors was inaccurately documented
Potential for TAPSE reduction related to ventilator employment cannot be wholly dismissed
Monocentric design
Mechanical ventilation interplays were not warranted

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Implication

May aid risk stratification in septic shock; hypothesis-generating and should not change practice without validation.

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.

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Cite This Study

Habib et al. (2025) conducted a cohort in Septic shock (n=100). Tricuspid annular plane systolic excursion (TAPSE) measurement was evaluated on 28-day mortality (AUC 0.887, 95% CI 0.770-0.980, p=<0.0001). In noncardiac patients with septic shock, a tricuspid annular plane systolic excursion (TAPSE) of less than 2 cm strongly predicted 28-day mortality with an area under the curve of 0.887.

synapsesocial.com/papers/6a18e02104206f6c9d9066e0 https://doi.org/10.1186/s44158-025-00227-0

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

Figures

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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

Figures

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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