Key result
Non-improved serial TAPSE linked to ~72% higher 60-day mortality vs. improved TAPSE.
Why the study?
The prognostic relevance of serial change in TAPSE among critically ill adults with reduced baseline TAPSE was uncertain.
Does non-improved serial TAPSE predict higher 60-day mortality in critically ill adults with reduced baseline TAPSE?
Cohort (n=227)
Does non-improved serial TAPSE predict higher 60-day mortality in critically ill adults with reduced baseline TAPSE?
A lack of improvement in serial TAPSE over a median 10 days is associated with higher 60-day mortality in critically ill adults, though it does not provide prognostic value beyond a single follow-up TAPSE measurement.
Follow-up TAPSE may suffice for 60-day mortality risk assessment in critical RV dysfunction; leaves open incremental value of serial monitoring.
Background/Objectives: Tricuspid annular plane systolic excursion (TAPSE) is routinely available in critical-care echocardiography, but the prognostic relevance of serial change is uncertain. We examined serial TAPSE and subsequent mortality among critically ill adults with reduced baseline TAPSE. Methods: This retrospective MIMIC-IV-ECHO cohort included adults with at least two TAPSE measurements and baseline TAPSE < 1.7 cm. Serial TAPSE status was classified as improved (increase >0.2 cm) or non-improved (change ≤0.2 cm). Cox regression evaluated 60-day mortality from the follow-up echocardiogram. Results: Among 227 patients, 101 (44.5%) were improved and 126 (55.5%) non-improved over a median interval of 10 days. Non-improved status was associated with higher subsequent mortality (adjusted hazard ratio 1.72, 95% confidence interval 1.06–2.80; p = 0.028). After adjustment for follow-up TAPSE, neither binary status nor continuous change was significantly associated with mortality. Conclusions: In this exploratory study, non-improved serial TAPSE was associated with higher 60-day mortality. Added prognostic value beyond follow-up TAPSE was not demonstrated.
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Zhai et al. (2026) conducted a cohort in Critically ill adults with reduced baseline TAPSE (n=227). Non-improved serial TAPSE (change ≤0.2 cm) vs. Improved serial TAPSE (increase >0.2 cm) was evaluated on 60-day mortality (HR 1.72, 95% CI 1.06-2.80, p=0.028). Non-improved serial TAPSE was associated with higher 60-day mortality compared to improved TAPSE (HR 1.72; 95% CI 1.06-2.80; p=0.028).
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