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ISSN 2448-8909 (Print)

2023, Number 7

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Med Crit 2023; 37 (7)

Association of the TAPSE/PSAP index and mortality in patients admitted to intensive care with right ventricular dysfunction treated with levosimendan

Núñez GP, Gaytán GC, González MO, Mora RP, Aguirre SJS, Martínez DB

Language: Spanish
References: 37
Page: 582-592
PDF size: 287.23 Kb.


ABSTRACT

Introduction: to evaluate right ventricular dysfunction, measures such as TAPSE and PSAP are used, whose ratio (TAPSE/PSAP) can be predictors of in-hospital mortality. On the other hand, levosimendan is a drug that is commonly used in left heart failure, and may also be effective in the treatment of right ventricular failure. However, the available evidence is contradictory regarding the association between the use of levosimendan, right ventricular dysfunction parameters, and in-hospital mortality. Objective: to evaluate the association of the TAPSE/PSAP index ≤ 0.31 mm/mmHg and mortality in patients admitted to the Critical Care Medicine Unit with right ventricular dysfunction who received levosimendan. Material and methods: retrospective cohort, a consecutive sample of patients of legal age, until reaching the sample size of 54, with a diagnosis of acute right heart failure due to any etiology who have been admitted to the Critical Care Medicine Unit, who received at least minus one dose of levosimendan with echocardiogram (TAPSE, PSAP). TAPSE/PSAP was associated with in-hospital mortality. Results: we included 78 patients of which the majority (43, 55.1%) were men, median age 73 years (18-95), most common comorbidities: diabetes (25.6%) and arterial hypertension (55.1%), sepsis (43, 55.1%) was the most common diagnosis. The TAPSE/PSAP index was > 0.32 in the majority of patients (65.3%), median 0.32 (range 0.107-0.771). Twenty-four patients (30.8%) died. Measurements of TAPSE, TAPSE/PSAP index, SOFA, and days on levosimendan were similar between patients who died and those who lived. Conclusions: this study evaluated the usefulness of the TAPSE/PSAP index with a cut-off point < 31 mm/mmHg as a predictor of mortality in patients in the Intensive Care Unit with right ventricular dysfunction who received treatment with Levosimendan. The results suggest that this index is not a reliable marker to predict the risk of mortality in this population (OR 0.921, 95% CI 0.333-2.544, r2 0.0).


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