Zhang HM,Wang XT,Zhang LN,He W,Zhang Q,Liu DW;Chinese Critical Ultrasound Study Group.(CCUSG).

Abstract

Background

SepticCardiomyopathyis a common finding in septic shock patients. The accepted definition of septic cardiomyopathy isoften based on the left ventricular ejection fraction (LVEF). The aim of this study was to determine whether the left ventricular longitudinalSystolicFunctionwas more sensitive than the LVEF inHeartfunction appraisal of septic shock patients.

Methods

This was a case-control study conducted at a 40‑bed Intensive Care Unit (ICU) of Peking Union Medical College Hospital.Septic shock patients admitted to the ICU were consecutively enrolled in the study group from March 1, 2016 to September 1, 2016. Thecontrol group was selected from nonsepsis patients who were admitted to the ICU and were comparable to the study group.TransthoracicEchocardiographywas performed to obtain the LVEF measurement, mitral annular plane systolic excursion (MAPSE), tissue Dopplervelocity measurement of mitral annulus (Sa), and tricuspid annular plane systolic excursion.

Results

The study group consisted of 45 septic shock patients. Another 45 nonsepsis patients were selected as the control group. Therewas no difference in the LVEF between the two groups (64.6% vs. 67.2%, t = −1.426, P = 0.161). MAPSE in the study group was muchlower than in the control group (1.2 cm vs. 1.5 cm, t = −4.945, P < 0.001). Sa in the study group was also lower than in the controlgroup (10.2 cm/s vs. 11.8 cm/s, t = −2.796, P = 0.014).

Conclusions

Compared to the LVEF, longitudinal systolic function might be more sensitive in the detection of cardiac depression inseptic shock patients. In the heart function appraisal of septic shock patients with a normal ejection fraction, more attention should begiven to longitudinal function parameters such as MAPSE and Sa.

Key words

Cardiomyopathy; Heart Function; Systolic; Transthoracic Echocardiography

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