Related Experiment Video
Updated: May 30, 2026
08:45
Echocardiographic Assessment Using Subxiphoid-Only Examination for Hypotensive Patients
Published on: April 18, 2025
Ventricular dysfunction and dilation in severe sepsis and septic shock: relation to endothelial function and
Thiago Furian1, Cyntia Aguiar, Karen Prado
1Cardiology and Cardiovascular Sciences, Medical School from Rio Grande doSul Federal University, Brasil.
Journal of Critical Care
|August 23, 2011
Summary
Severe sepsis frequently causes left and right ventricular dysfunction, linked to endothelial dysfunction. Echocardiography can identify poor prognosis indicators like RV dysfunction and diastolic dysfunction.
Area of Science:
- Cardiology
- Critical Care Medicine
- Pathophysiology
Background:
- Severe sepsis presents a significant challenge in critical care, often leading to multi-organ dysfunction.
- Early identification of cardiac involvement in sepsis is crucial for patient outcomes.
Purpose of the Study:
- To assess echocardiography-derived myocardial function indices in early severe sepsis.
- To evaluate markers of vascular inflammation and endothelial dysfunction in sepsis.
- To correlate cardiac function with inflammatory markers and patient prognosis.
Main Methods:
- Studied 45 adult severe sepsis patients within 24 hours of ICU admission.
- Collected clinical, laboratorial (endothelin 1, vascular cellular adhesion molecule 1), and echocardiographic data at baseline, 72 hours, and 7 days.
- Analyzed left ventricular (LV) and right ventricular (RV) function, including ejection fraction and RV-Sm.
Main Results:
- 33% intrahospital mortality observed.
- 15 patients (33%) had LV dysfunction and 14 (30%) had RV dysfunction.
- Elevated endothelin 1 correlated with LV and RV dysfunction and negatively with LV ejection fraction and RV-Sm.
- LV end-diastolic diameter, RV-Sm, and diastolic dysfunction predicted mortality.
Conclusions:
- Prevalent LV and RV systolic dysfunctions occur in severe sepsis.
- These dysfunctions are directly associated with endothelial dysfunction markers.
- Nondilated LV, RV dysfunction, and diastolic dysfunction indicate a poor prognosis.
Related Concept Videos
01:29Heart Failure II: Pathophysiology
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
01:30Cardiomyopathy II: Dilated Cardiomyopathy
Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
01:20Mitral Regurgitation I: Introduction
Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
01:22Mitral Stenosis I: Introduction
Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
01:18Pulmonary Edema II: Pathophysiology
Pulmonary edema is the accumulation of fluid in the interstitial and alveolar spaces of the lungs, impairing gas exchange and oxygen delivery. It may be cardiogenic or noncardiogenic, but both reduce oxygenation and lung compliance.Cardiogenic Pulmonary EdemaCardiogenic edema results from increased hydrostatic pressure in pulmonary capillaries, usually due to left ventricular dysfunction from myocardial infarction, heart failure, or valvular disease. Ineffective cardiac pumping causes blood to...
01:29Endocarditis IV: Nursing Management
Infective endocarditis (IE) is a chronic infection of the heart's endocardium, primarily affecting the heart valves. A detailed nursing assessment for a patient with IE involves collecting subjective and objective data to ensure an accurate diagnosis and timely intervention.Subjective DataThe nurse gathers information about the patient's symptoms and complaints during the subjective assessment. Patients with infective endocarditis often report non-specific symptoms that can mimic other...