Interval Changes in Myocardial Performance Index Predict Outcome in Severe Sepsis

Area of Science:

• Cardiology
• Critical Care Medicine
• Echocardiography

Background:

• Septic cardiomyopathy is a known complication of septic shock, contributing to increased mortality.
• Traditional cardiac function metrics may be less sensitive in assessing global cardiac function during sepsis.

Purpose of the Study:

• To investigate the association between changes in left ventricular myocardial performance index (MPI) and 90-day mortality in patients with severe sepsis.
• To determine if MPI is a sensitive predictor of outcomes in septic cardiomyopathy.

Main Methods:

• Prospective, observational study in intensive care units involving 47 patients with severe sepsis or septic shock.
• Transthoracic echocardiograms were performed at enrollment and 24 hours to assess MPI.
• Analysis focused on the correlation between MPI change and 90-day sepsis-related mortality.

Main Results:

• Of 47 patients, 30 showed improved MPI, while 17 experienced worsening MPI within 24 hours.
• Worsening MPI was significantly associated with increased 90-day mortality (p = 0.04), even after adjusting for illness severity and treatments.
• No significant differences in ejection fraction or illness severity were noted between groups initially.

Conclusions:

• A worsening myocardial performance index during the initial 24 hours in the ICU predicts higher 90-day mortality in severe sepsis and septic shock patients.
• MPI serves as a valuable, sensitive tool for assessing cardiac function and prognosis in sepsis.