Related Experiment Video
Updated: May 29, 2026
08:45
Echocardiographic Assessment Using Subxiphoid-Only Examination for Hypotensive Patients
Published on: April 18, 2025
Diastolic dysfunction and mortality in severe sepsis and septic shock
Giora Landesberg1, Dan Gilon, Yuval Meroz
1Department of Anesthesiology and Critical Care Medicine, Hadassah - Hebrew University Medical Center, Jerusalem 91120, Israel. gio@cc.huji.ac.il
European Heart Journal
|September 14, 2011
Summary
Diastolic dysfunction in sepsis is a significant predictor of mortality, often overlooked compared to systolic dysfunction. Early identification of diastolic dysfunction improves sepsis outcome prediction.
Area of Science:
- Cardiology
- Critical Care Medicine
- Sepsis Research
Background:
- Systolic dysfunction in septic shock is recognized and paradoxically linked to better outcomes.
- Diastolic dysfunction in sepsis is often overlooked, and its impact on early mortality is understudied.
Purpose of the Study:
- To investigate the role of diastolic dysfunction in predicting early mortality in patients with severe sepsis or septic shock.
Main Methods:
- Prospective cohort study of 262 intensive care unit patients with severe sepsis/septic shock.
- Two early echocardiography examinations were performed.
- Clinical, laboratory, and survival data were collected, including APACHE-II scores and cardiac biomarkers.
Main Results:
- Reduced mitral annular e'-wave (diastolic dysfunction) was the strongest mortality predictor (P<0.0001).
- Patients with diastolic dysfunction (alone or combined with systolic dysfunction) had significantly higher mortality rates (HR=6.0 and 6.2, P<0.0001).
- Elevated N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels were markedly higher and predicted mortality.
Conclusions:
- Diastolic dysfunction is prevalent in severe sepsis and septic shock.
- Diastolic dysfunction is a critical, independent predictor of mortality in sepsis.
- Echocardiographic assessment of diastolic function is crucial for risk stratification in sepsis patients.
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...
01:22Mitral 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...
01:30Cardiomyopathy 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,...
01:26Imbalances in Cardiac Output
The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...
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...
01:24Blood Pressure Imbalances and Circulatory Shock
Disorders affecting blood volume, vascular tone, or vascular function can disrupt vascular homeostasis, including conditions like hypertension, hemorrhage, and shock.
Blood Pressure: Hypertension and Hypotension
Normal blood pressure is 120/80 mm Hg. Elevated blood pressure is 120-129/under 80 mm Hg. Hypertension, warranting treatment at 130/80 mm Hg, is often asymptomatic and can lead to severe cardiovascular events, aneurysms, peripheral arterial disease, chronic renal disease, or cardiac...
Blood Pressure: Hypertension and Hypotension
Normal blood pressure is 120/80 mm Hg. Elevated blood pressure is 120-129/under 80 mm Hg. Hypertension, warranting treatment at 130/80 mm Hg, is often asymptomatic and can lead to severe cardiovascular events, aneurysms, peripheral arterial disease, chronic renal disease, or cardiac...