Saraschandra Vallabhajosyula1, Jeffrey B Geske2, Mukesh Kumar3, Rahul Kashyap3, Kianoush Kashani4, Jacob C Jentzer5. 1. Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States; Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, United States; Multidisciplinary Epidemiology and Translational Research in Intensive Care (METRIC) Laboratory, Mayo Clinic, Rochester, MN, United States; Center for Clinical and Translational Science, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic, Rochester, MN, United States. Electronic address: Vallabhajosyula.Saraschandra@mayo.edu. 2. Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States. 3. Multidisciplinary Epidemiology and Translational Research in Intensive Care (METRIC) Laboratory, Mayo Clinic, Rochester, MN, United States; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, United States. 4. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, United States; Multidisciplinary Epidemiology and Translational Research in Intensive Care (METRIC) Laboratory, Mayo Clinic, Rochester, MN, United States; Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN, United States. 5. Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States; Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, United States.
Abstract
BACKGROUND: The association of pulmonary hypertension (PH) in patients with sepsis is lesser understood. METHODS: This was a retrospective study of adult patients admitted to the intensive care unit during 2007-2014 for sepsis and septic shock, with echocardiography performed <72 h. PH was defined as tricuspid regurgitation peak velocity (TRV) > 3 m/s on Doppler echocardiography. Patients with prior PH, pulmonary stenosis, or without measurable TRV were excluded. Outcomes included 28-day mortality, one-year survival and length of stay. RESULTS: Eighty-three, of 241 (34.4%) patients included, had PH. Patients with PH were older and had greater cardiovascular comorbidity but similar illness severity, including acute respiratory distress syndrome and mechanical ventilation use. PH was an independent predictor of 28-day mortality (odds ratio 3.6 [95% confidence interval 1.1-12.5] p = .04). In a proportional hazards model, PH was an independent predictor of one-year survival (hazard ratio 1.7 [95% confidence interval 1.1-2.7]; p = .03). Severity of PH was associated with worse one-year survival but not 28-day mortality. CONCLUSIONS: In patients with sepsis and septic shock, PH is common and is noted to be associated with higher short and long-term mortality. Further studies are needed to understand the mechanisms by which PH is associated with outcomes.
BACKGROUND: The association of pulmonary hypertension (PH) in patients with sepsis is lesser understood. METHODS: This was a retrospective study of adult patients admitted to the intensive care unit during 2007-2014 for sepsis and septic shock, with echocardiography performed <72 h. PH was defined as tricuspid regurgitation peak velocity (TRV) > 3 m/s on Doppler echocardiography. Patients with prior PH, pulmonary stenosis, or without measurable TRV were excluded. Outcomes included 28-day mortality, one-year survival and length of stay. RESULTS: Eighty-three, of 241 (34.4%) patients included, had PH. Patients with PH were older and had greater cardiovascular comorbidity but similar illness severity, including acute respiratory distress syndrome and mechanical ventilation use. PH was an independent predictor of 28-day mortality (odds ratio 3.6 [95% confidence interval 1.1-12.5] p = .04). In a proportional hazards model, PH was an independent predictor of one-year survival (hazard ratio 1.7 [95% confidence interval 1.1-2.7]; p = .03). Severity of PH was associated with worse one-year survival but not 28-day mortality. CONCLUSIONS: In patients with sepsis and septic shock, PH is common and is noted to be associated with higher short and long-term mortality. Further studies are needed to understand the mechanisms by which PH is associated with outcomes.
Authors: Jacob C Jentzer; Brandon M Wiley; Yogesh N V Reddy; Christopher Barnett; Barry A Borlaug; Michael A Solomon Journal: Eur Heart J Acute Cardiovasc Care Date: 2022-03-16
Authors: Saraschandra Vallabhajosyula; Shiva P Ponamgi; Sanskriti Shrivastava; Pranathi R Sundaragiri; Virginia M Miller Journal: FASEB J Date: 2020-07 Impact factor: 5.191
Authors: Saarwaani Vallabhajosyula; Zhen Wang; M Hassan Murad; Shashaank Vallabhajosyula; Pranathi R Sundaragiri; Kianoush Kashani; Wayne L Miller; Allan S Jaffe; Saraschandra Vallabhajosyula Journal: Mayo Clin Proc Innov Qual Outcomes Date: 2020-01-08
Authors: Saraschandra Vallabhajosyula; Aditi Shankar; Sri Harsha Patlolla; Abhiram Prasad; Malcolm R Bell; Jacob C Jentzer; Shilpkumar Arora; Saarwaani Vallabhajosyula; Bernard J Gersh; Allan S Jaffe; David R Holmes; Shannon M Dunlay; Gregory W Barsness Journal: ESC Heart Fail Date: 2020-04-02