Detection of Myocardial Dysfunction in Septic Shock
- 1 December 2015
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Anesthesia & Analgesia
- Vol. 121 (6), 1547-1554
- https://doi.org/10.1213/ane.0000000000000943
Abstract
Patients with septic shock are at increased risk of myocardial dysfunction. However, the left ventricular ejection fraction (EF) typically remains preserved in septic shock. Strain measurement using speckle-tracking echocardiography may quantify abnormalities in myocardial function not detected by conventional echocardiography. To investigate whether septic shock results in greater strain changes than sepsis alone, we evaluated strain in patients with sepsis and septic shock. We prospectively identified 35 patients with septic shock and 15 with sepsis. These patients underwent serial transthoracic echocardiograms at enrollment and 24 hours later. Measurements included longitudinal, radial, and circumferential strain in addition to standard echocardiographic assessments of left ventricular function. Longitudinal strain worsened significantly over 24 hours in patients with septic shock (P CONCLUSIONS: In patients with septic shock, but not sepsis, myocardial strain imaging using speckle-tracking echocardiography identified myocardial dysfunction in the absence of changes in EF. These data suggest that strain imaging may play a role in cardiovascular assessment during septic shock.Keywords
This publication has 33 references indexed in Scilit:
- Perioperative Assessment of Myocardial DeformationAnesthesia & Analgesia, 2014
- Effect of Heart Rate Control With Esmolol on Hemodynamic and Clinical Outcomes in Patients With Septic ShockJAMA, 2013
- Nonischemic Myocardial Changes Detected by Cardiac Magnetic Resonance in Critical Care Patients with SepsisAmerican Journal of Respiratory and Critical Care Medicine, 2013
- Histologic Pathologies of the Myocardium in Septic ShockShock, 2013
- Mechanisms of Cardiac and Renal Dysfunction in Patients Dying of SepsisAmerican Journal of Respiratory and Critical Care Medicine, 2013
- Clinical Spectrum, Frequency, and Significance of Myocardial Dysfunction in Severe Sepsis and Septic ShockMayo Clinic Proceedings, 2012
- Diastolic dysfunction and mortality in early severe sepsis and septic shock: a prospective, observational echocardiography studyThe Ultrasound Journal, 2012
- Current and Evolving Echocardiographic Techniques for the Quantitative Evaluation of Cardiac Mechanics: ASE/EAE Consensus Statement on Methodology and Indications Endorsed by the Japanese Society of EchocardiographyEuropean Heart Journal - Cardiovascular Imaging, 2011
- Macroscopic Postmortem Findings in 235 Surgical Intensive Care Patients with SepsisAnesthesia & Analgesia, 2009
- Mechanisms of sepsis-induced cardiac dysfunctionCritical Care Medicine, 2007