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Open Access 01-06-2012 | Research

The prognostic value of left ventricular systolic function measured by tissue Doppler imaging in septic shock

Authors: Li Weng, Yong-tai Liu, Bin Du, Jian-fang Zhou, Xiao-xiao Guo, Jin-min Peng, Xiao-yun Hu, Shu-yang Zhang, Quan Fang, Wen-ling Zhu

Published in: Critical Care | Issue 3/2012

Abstract

Introduction

Left ventricular (LV) dysfunction is common in septic shock. Its association with the clinical outcome is still controversial. Tissue Doppler imaging (TDI) is a useful tool to quantify LV function; however, little knowledge is available about the prognostic value of these TDI variables in septic shock. Therefore, we performed this prospective study to determine the role of TDI variables in septic shock.

Methods

Patients with septic shock in a medical intensive care unit were studied with transthoracic echocardiography with TDI within 24 hours after the onset of septic shock. Baseline clinical, laboratory, and echocardiographic variables were prospectively collected. Independent predictors of 90-day mortality were analyzed with the Cox regression model.

Results

During a 20-month period, 61 patients were enrolled in the study. The 90-day mortality rate was 39%; the mean APACHE IV score was 84 (68 to 97). Compared with survivors, nonsurvivors exhibited significantly higher peak systolic velocity measured at the mitral annulus (Sa) (11.0 (9.1 to 12.5) versus 7.8 (5.5 to 9.0) cm/sec; P < 0.0001), lower PaO₂/FiO₂ (123 (83 to 187) versus 186 (142 to 269) mm Hg; P = 0.002], higher heart rate (120 (90 to 140) versus 103 (90 to 114) beats/min; P = 0.004], and ahigher dose of norepinephrine (0.6 (0.2 to 1.0) versus 0.3 (0.2 to 0.5) μg/kg/min; P = 0.007]. In the multivariate analysis, Sa > 9 cm/sec (hazard ratio (HR), 5.559; 95% confidence interval (CI), 2.160 to 14.305; P < 0.0001), dose of norepinephrine (HR, 1.964; 95% CI, 1.338 to 2.883; P = 0.001), and PaO₂/FiO₂ (HR, 0.992; 95% CI, 0.984 to 0.999; P = 0.031) remain independent predictors of 90-day mortality in septic-shock patients.

Conclusions

Our study demonstrated that LV systolic function as determined by TDI, in particular, Sa, might be associated with mortality in patients with septic shock.

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Title: The prognostic value of left ventricular systolic function measured by tissue Doppler imaging in septic shock
Authors: Li Weng
Yong-tai Liu
Bin Du
Jian-fang Zhou
Xiao-xiao Guo
Jin-min Peng
Xiao-yun Hu
Shu-yang Zhang
Quan Fang
Wen-ling Zhu
Publication date: 01-06-2012
Publisher: BioMed Central
Published in: Critical Care / Issue 3/2012
Electronic ISSN: 1364-8535
DOI: https://doi.org/10.1186/cc11328

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The prognostic value of left ventricular systolic function measured by tissue Doppler imaging in septic shock

Abstract

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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