P793Tricuspid annular plane systolic excursion predicts short term survival in patients with acute exacerbation of COPD.


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Abstract

Purpose: Right ventricle (RV) function was successfully evaluated by tricuspid annular plane systolic excursion (TAPSE).Recent studies had shown TAPSE as prognosis parameter in patients with heart failure and patients with pulmonary hypertension.The aim of our study is to evaluate this parameter in patients admitted to the ICU for acute exacerbation of COPD requiring mechanical ventilation assistance.Patients and methods: Patients admitted to ICU for AECOPD requiring Non invasive positive Pressure Ventilation (NPPV) during the study protocol were included in the study. Demographic data, clinical and laboratory parameters were recorded on admission. A Doppler echocardiography was done on admission (LVEF, diastolic function of LV, RV diameter, systolic pulmonary artery pressure and TAPSE recorded on M mode). A comparison of data was done between survivors and non survivors.Results: One hundred twenty four patients were included in study, mean age 58 y. Twenty one patients (17%) died in the ICU. Comparison between survivors and non survivors did not show any difference on demographic, clinical and laboratory finding. Non survivors had lower but not significant LVEF, but significant lower TAPSE (14.5 ± 2.7 mm vs 19.3 ± 3.0 mm; p = 0.0001). A cut-off value of TAPSE ≥ 17mm can predict survivors with a sensitivity of 88% and a specificity of 92%. The area under the curve of the receiver operating characteristic curve was 0.94. RV diameter, systolic pulmonary artery pressure and diastolic function of the LV did not differ between survivors and non survivors.Conclusion: The present study shows that TAPSE is simple robust measure of right function in patients with acute exacerbation of COPD which also has important prognostic implications for patients with AECOPD. Thus, TAPSE should be incorporated as routine echocardiographic assessment of patients with AECOPD.

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