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Association between right ventricle dysfunction and poor outcome in patients with septic shock
June-Sung Kim1, Youn-Jung Kim1, Muyeol Kim1
1Department of Emergency Medicine, Asan Medical Center, Songpa-gu, Seoul, Republic of Korea.
Heart (British Cardiac Society)
|July 10, 2020
Summary
Sepsis-induced myocardial dysfunction (SIMD) affects one-third of septic shock patients. While left ventricle dysfunction is common, only right ventricle dysfunction independently predicts higher short-term mortality in sepsis.
Area of Science:
- Cardiology
- Critical Care Medicine
- Echocardiography
Background:
- Sepsis-induced myocardial dysfunction (SIMD) is a complex complication affecting both ventricles.
- Characteristics and outcomes of different SIMD manifestations are not well understood.
Purpose of the Study:
- To investigate the prevalence, characteristics, and outcomes of various forms of SIMD in septic shock patients.
- To identify specific echocardiographic patterns of SIMD associated with mortality.
Main Methods:
- Retrospective cohort study of 778 septic shock patients with echocardiography within 72 hours of admission.
- Classification of SIMD into left ventricle (LV) systolic/diastolic and right ventricle (RV) dysfunction using American Society of Echocardiography criteria.
- Primary outcome: 28-day mortality.
Main Results:
- 270 (34.7%) patients had SIMD. Common forms included LV systolic dysfunction (67.3%) and RV dysfunction (40.7%).
- SIMD patients had higher troponin I, 28-day mortality (35.9%), longer ICU stay, and mechanical ventilation duration.
- Isolated RV dysfunction was an independent risk factor for 28-day mortality (OR 2.26).
Conclusions:
- Myocardial dysfunction is prevalent in septic shock, with diverse presentations.
- Right ventricle dysfunction, specifically, is a significant predictor of short-term mortality in septic shock patients.
Keywords:
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