Pulmonary hypertension (PH) detected on echocardiography is a strong prognostic indicator in critically ill patients, according to findings published in the American Journal of Cardiology.

The analysis included 3,085 admissions to the Mayo Clinic Cardiac Intensive Care Unit (CICU) from 2007 to 2018, all of whom underwent transthoracic echocardiography (TTE) within one day of admission. PH was defined as right ventricular systolic pressure (RVSP) ≥36 mmHg. The median age was 74 years, and 43.5% were women. Overall, 10.9% of patients died during hospitalization.

In-hospital deaths were characterized by higher RVSP (51 vs. 47 mmHg; p < 0.001) and elevated right atrial (RA) pressure (14 vs. 10 mmHg; p < 0.001). Indices of right ventricle–pulmonary artery (RV–PA) coupling, including the tricuspid S′ velocity–to–RVSP ratio and pulmonary artery elastance, were the strongest predictors of mortality (AUC 0.72).

These results highlight that TTE-derived parameters reflecting right heart loading and RV–PA interaction can help identify high-risk patients early, enabling more personalized hemodynamic monitoring and management in the CICU.