Prognostic value of left ventricular-arterial coupling in elderly patients with septic shock

Abstract Purpose To investigate the predictive value of left ventricular-arterial coupling (VAC) for clinical prognosis of elderly patients with septic shock. Materials and methods This was a single-center prospective cohort study of 63 elderly patients with septic shock treated between August 2014 and January 2016 at the 30-bed intensive care unit (ICU) of Zhejiang Hospital (China). Left VAC was evaluated by transthoracic echocardiography (TTE). End-systolic elastance (Ees) and left ventricular ejection fraction (LVEF) were measured; arterial elastance (Ea) was calculated. The 28-day survival was evaluated. Results Compared with non-survivors, survivors had a significantly lower Ea/Ees ratio ( P P P  = 0.720). LVEF was greater (47.5 ± 7.3 vs. 43.6 ± 6.4, P  = 0.03); LVESV was smaller in survivors compared to non-survivors ( P P  = 0.04), blood lactate levels (HR = 1.21, 95%CI:1.07–1.36, P  = 0.002), and VAC (HR = 2.57, 95%CI:1.29–5.13, P  = 0.007) were independently associated with 28-day mortality of elderly patients with septic shock. The optimal cutoff point of VAC for predicting 28-day mortality was 2.14 with 56.7% sensibility and 87.9% specificity; the area under the curve was 0.74. Conclusions Left VAC has prognostic value in elderly patients with septic shock.