Left Ventricular Longitudinal Systolic Function in Septic Shock Patients with Normal Ejection Fraction: A
Hong-Min Zhang1, Xiao-Ting Wang1, Li-Na Zhang2
1Department of Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China.
Insights
Septic cardiomyopathy can be detected earlier using longitudinal systolic function (LSF) than left ventricular ejection fraction (LVEF). LSF parameters like mitral annular plane systolic excursion (MAPSE) and tissue Doppler velocity (Sa) are more sensitive indicators of cardiac dysfunction in septic shock patients.
Area of Science:
- Cardiology
- Critical Care Medicine
- Echocardiography
Background:
- Septic cardiomyopathy is a frequent complication in septic shock.
- Left ventricular ejection fraction (LVEF) is the standard measure for septic cardiomyopathy.
- Early detection of cardiac dysfunction is crucial for patient outcomes.
Purpose of the Study:
- To compare the sensitivity of left ventricular longitudinal systolic function (LSF) versus LVEF in assessing heart function in septic shock patients.
- To identify more sensitive echocardiographic parameters for cardiac depression in sepsis.
Main Methods:
- A case-control study involving 45 septic shock patients and 45 non-sepsis controls.
- Transthoracic echocardiography was used to measure LVEF, mitral annular plane systolic excursion (MAPSE), and tissue Doppler velocity (Sa).
- Comparison of LSF parameters and LVEF between septic shock and control groups.
Main Results:
- No significant difference in LVEF was observed between septic shock and control groups (P=0.161).
- MAPSE was significantly lower in septic shock patients compared to controls (P<0.001).
- Sa was also significantly reduced in septic shock patients (P=0.014).
Conclusions:
- Longitudinal systolic function (LSF) parameters, including MAPSE and Sa, are more sensitive than LVEF in detecting cardiac depression in septic shock.
- Clinicians should prioritize LSF assessment in septic shock patients, especially those with normal LVEF.
- LSF parameters offer a more sensitive approach to heart function appraisal in septic shock.
Background:
Septic cardiomyopathy is a common finding in septic shock patients. The accepted definition of septic cardiomyopathy is often based on the left ventricular ejection fraction (LVEF). The aim of this study was to determine whether the left ventricular longitudinal systolic function was more sensitive than the LVEF in heart function appraisal of septic shock patients.
Methods:
This was a case-control study conducted at a 40-bed Intensive Care Unit (ICU) of Peking Union Medical College Hospital. Septic shock patients admitted to the ICU were consecutively enrolled in the study group from March 1, 2016 to September 1, 2016. The control group was selected from nonsepsis patients who were admitted to the ICU and were comparable to the study group. Transthoracic echocardiography was performed to obtain the LVEF measurement, mitral annular plane systolic excursion (MAPSE), tissue Doppler velocity measurement of mitral annulus (Sa), and tricuspid annular plane systolic excursion.
Results:
The study group consisted of 45 septic shock patients. Another 45 nonsepsis patients were selected as the control group. There was no difference in the LVEF between the two groups (64.6% vs. 67.2%, t= -1.426, P= 0.161). MAPSE in the study group was much lower than in the control group (1.2 cm vs. 1.5 cm, t= -4.945, P< 0.001). Sa in the study group was also lower than in the control group (10.2 cm/s vs. 11.8 cm/s, t = -2.796, P= 0.014).
Conclusions:
Compared to the LVEF, longitudinal systolic function might be more sensitive in the detection of cardiac depression in septic shock patients. In the heart function appraisal of septic shock patients with a normal ejection fraction, more attention should be given to longitudinal function parameters such as MAPSE and Sa.
