Prognostic value of right ventricle–pulmonary artery coupling in intensive cardiac care unit

Background The modern intensive cardiac care unit (ICCU) demands new, reliable prognostic tools. We aimed to investigate the prognostic role of the right ventricle–pulmonary artery (RV-PA) coupling, assessed by the echocardiographic ratio between the tricuspid annular plane systolic excursion (TAPSE) and the systolic pulmonary artery pressure (sPAP), in an unselected population admitted to the ICCU. Methods and results One thousand six hundred and six patients were retrospectively identified from an internal database. After propensity matching, a TAPSE/sPAP ratio less than 0.51 was strongly associated with 30-day mortality odds ratio (OR) 1.76, 95% confidence interval (CI) 1.12–2.66; P = 0.014, but not with long-term mortality (hazard ratio 1.3, 95% CI 0.87–1.89; P = 0.2). Major findings In an unselected, mixed ICCU population, the RV coupling assessment is feasible and strongly associated with 30-day mortality.