[Occurrence and outcome of left ventricular-arterial coupling in sepsis-induced cardiomyopathy]

To explore the occurrence and development of sepsis-induced cardiomyopathy (SIC) and its correlation with left ventricular arterial coupling.

A total of 46 SIC patients were recruited and divided into non-survival and survival groups. And hemodynamics parameters, lactate, cardiac elastance (Ees), arterial elastance (Ea) and ventricular-arterial coupling (Ea/Ees), stroke work (SW), total mechanical work (PVA) and cardiac work efficiency (SW/PVA) were recorded before and after an onset of SIC.

The occurrence and development of SIC had close correlations with left ventricular arterial coupling.Heart and arterial elastance affected the occurrence and outcome of SIC. The former was a underlying cause while the latter a precipitating factor; the primary treatment goal of SIC was improving ventricular-arterial coupling. And the short-term objective was reducing arterial elastance and long-term strategy improving cardiac elastance; Ea declined initially when SIC recovered. And it was consistent with ventricular-arterial coupling improvement. Ees recovery was delayed; before and after SIC, low peripheral vascular resistance within 36 h could reduce arterial elastance Ea; ventricular artery coupling affected cardiac external work, work efficiency and stroke volume and was associated with tissue perfusion.

The occurrence and outcome of SIC are simultaneously influenced by Ees and Ea and are closely correlated with Ea/Ees. Treatment goal of SIC is improving ventricular-arterial coupling.Ea should be reduced within 36 h and Ees should be boosted after 48 h.