open access

Vol 88, No 5 (2020)
Research paper
Submitted: 2020-03-04
Accepted: 2020-05-24
Published online: 2020-10-24
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Echocardiographic assessment of the right ventricle and its correlation with patient outcome in acute respiratory distress syndrome

Ahmed Taha1, Tayseer Zaytoun1, Hany Eid1, Ayman Baess2, Ehab Elreweny1
DOI: 10.5603/ARM.a2020.0153
·
Pubmed: 33169813
·
Adv Respir Med 2020;88(5):412-419.
Affiliations
  1. Department of Critical Care Medicine, Faculty of Medicine, Alexandria University, Egypt
  2. Department of Chest Diseases, Faculty of Medicine, Alexandria University, Egypt

open access

Vol 88, No 5 (2020)
ORIGINAL PAPERS
Submitted: 2020-03-04
Accepted: 2020-05-24
Published online: 2020-10-24

Abstract

Introduction: Acute respiratory distress syndrome (ARDS) is a life-threatening chest disease associated with a poor outcome and increased mortality. It may lead to pulmonary hypertension and, eventually, right ventricular failure. These changes can be investigated by transthoracic echocardiography (TTE) which is considered a non-invasive and cost-effective modality. We studied the role of right ventricular function in the prediction of the severity and mortality in ARDS.
Material and methods: In this observational study, 94 patients suffering from ARDS were subjected to TTE to evaluate the parameters of right ventricular function by measuring tricuspid annular plane systolic excursion (TAPSE), right ventricular fractional area change (RV-FAC), myocardial performance index (Tei index), and systolic pulmonary artery pressure (SPAP) to assess their relation to the severity and mortality in ARDS.
Results: TAPSE, SPAP, Tei index, and RV-FAC showed significant differences between survivors and non-survivors after 30 days (all p < 0.001). An increased length of intensive care unit stay was significantly correlated with TAPSE, Tei index, and RV-FAC (p = 0.002‚ 0.007‚ and 0.013, respectively). Meanwhile, the length of mechanical ventilation days was significantly correlated with the Tei index only (p < 0.001). Multivariate regression analysis found that TAPSE and the Tei index were independent factors affecting mortality (p = 0.004‚ and 0.006, respectively). RV-FAC, with a cut-off point ≤ 57%, had the highest sensitivity‚ while TAPSE, with a cut-off point ≤ 17 mm, had the highest specificity to predict mortality.
Conclusions: Transthoracic echocardiographic parameters of the right ventricle could be used to predict severity and mortality in patients with ARDS with high sensitivity and specificity.

Abstract

Introduction: Acute respiratory distress syndrome (ARDS) is a life-threatening chest disease associated with a poor outcome and increased mortality. It may lead to pulmonary hypertension and, eventually, right ventricular failure. These changes can be investigated by transthoracic echocardiography (TTE) which is considered a non-invasive and cost-effective modality. We studied the role of right ventricular function in the prediction of the severity and mortality in ARDS.
Material and methods: In this observational study, 94 patients suffering from ARDS were subjected to TTE to evaluate the parameters of right ventricular function by measuring tricuspid annular plane systolic excursion (TAPSE), right ventricular fractional area change (RV-FAC), myocardial performance index (Tei index), and systolic pulmonary artery pressure (SPAP) to assess their relation to the severity and mortality in ARDS.
Results: TAPSE, SPAP, Tei index, and RV-FAC showed significant differences between survivors and non-survivors after 30 days (all p < 0.001). An increased length of intensive care unit stay was significantly correlated with TAPSE, Tei index, and RV-FAC (p = 0.002‚ 0.007‚ and 0.013, respectively). Meanwhile, the length of mechanical ventilation days was significantly correlated with the Tei index only (p < 0.001). Multivariate regression analysis found that TAPSE and the Tei index were independent factors affecting mortality (p = 0.004‚ and 0.006, respectively). RV-FAC, with a cut-off point ≤ 57%, had the highest sensitivity‚ while TAPSE, with a cut-off point ≤ 17 mm, had the highest specificity to predict mortality.
Conclusions: Transthoracic echocardiographic parameters of the right ventricle could be used to predict severity and mortality in patients with ARDS with high sensitivity and specificity.

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Keywords

acute respiratory distress syndrome; transthoracic echocardiography; tricuspid annular plane systolic excursion; systolic pulmonary artery pressure; fractional area change

About this article
Title

Echocardiographic assessment of the right ventricle and its correlation with patient outcome in acute respiratory distress syndrome

Journal

Advances in Respiratory Medicine

Issue

Vol 88, No 5 (2020)

Article type

Research paper

Pages

412-419

Published online

2020-10-24

DOI

10.5603/ARM.a2020.0153

Pubmed

33169813

Bibliographic record

Adv Respir Med 2020;88(5):412-419.

Keywords

acute respiratory distress syndrome
transthoracic echocardiography
tricuspid annular plane systolic excursion
systolic pulmonary artery pressure
fractional area change

Authors

Ahmed Taha
Tayseer Zaytoun
Hany Eid
Ayman Baess
Ehab Elreweny

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