Acute left ventricular dilatation and shock-induced myocardial dysfunction.
Bélaïd Bouhemad1, Armelle Nicolas-Robin, Charlotte Arbelot
1Department of Anesthesiology, Réanimation Chirurgicale Pierre Viars, Hospital Practitioner, Assistance Publique Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, University Pierre et Marie Curie Paris-6, France. belaid.bouhemad@psl.aphp.fr
Critical Care Medicine
|December 31, 2008
Summary
Septic shock can cause acute, reversible left ventricular dilation and systolic dysfunction. However, if myocardial issues only affect relaxation, ventricular size remains stable.
Area of Science:
- Cardiology
- Intensive Care Medicine
- Septic Shock Research
Background:
- Septic myocardial dysfunction is a critical complication of sepsis.
- The impact of septic shock on cardiac ventricle size and function requires further elucidation.
Purpose of the Study:
- To investigate whether cardiac ventricles acutely dilate during septic myocardial dysfunction.
- To assess changes in left ventricular dimensions and function over 10 days in patients with septic shock.
Main Methods:
- Prospective echocardiographic study in a surgical intensive care unit.
- 45 patients with septic shock were monitored for 10 days.
- Measurements included left ventricular end-diastolic area (LVEDA), fractional area change (FAC), and cardiac troponin I (cTnI).
Main Results:
- Patients with increased cTnI and systolic dysfunction (group 2) showed significantly higher LVEDA at day 1.
- LVEDA and FAC in group 2 normalized within 10 days.
- A significant correlation between aortic flow and LVEDA/FAC was observed only in group 2.
Conclusions:
- Acute, reversible left ventricular dilation is associated with septic shock-induced systolic dysfunction.
- Left ventricular dimensions remain unchanged when myocardial abnormalities are limited to impaired relaxation.
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