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Related Experiment Videos

Left ventricular performance in septic shock: reversible segmental and global abnormalities.

A G Ellrodt, M S Riedinger, A Kimchi

    American Heart Journal
    |August 1, 1985
    PubMed
    Summary

    Left ventricular dysfunction is common in septic shock, often presenting as reduced ejection fraction and wall motion abnormalities. Underlying heart disease increases segmental dysfunction risk, impacting patient outcomes.

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    Area of Science:

    • Cardiology
    • Critical Care Medicine
    • Pathophysiology

    Background:

    • Left ventricular dysfunction is recognized in septic shock pathogenesis.
    • Its natural history, causes, and prognostic implications remain incompletely understood.

    Purpose of the Study:

    • To assess the natural history, causes, and prognostic significance of left ventricular dysfunction in septic shock.
    • To evaluate left ventricular performance using serial radionuclide and hemodynamic studies.

    Main Methods:

    • Serial radionuclide and hemodynamic assessments in 35 patients with culture-proven septic shock.
    • Analysis of left ventricular stroke work index, ejection fraction, wall motion abnormalities, and end-diastolic volume index.
    • Comparison of patients with and without antecedent heart disease.

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    Main Results:

    • 94% of patients showed depressed left ventricular stroke work index; 54% had ejection fraction < 0.48.
    • 63% exhibited segmental wall motion abnormalities.
    • Underlying heart disease correlated with higher segmental dysfunction (87% vs. 45%), but not ejection fraction or stroke work index.
    • Segmental abnormalities and low ejection fractions were associated with larger left ventricular end-diastolic volume index.
    • Conventional hemodynamic parameters and coronary perfusion pressure did not reliably predict dysfunction.

    Conclusions:

    • Left ventricular dysfunction, particularly segmental abnormalities, is prevalent in septic shock.
    • Antecedent heart disease is a risk factor for segmental dysfunction.
    • Left ventricular end-diastolic volume index may be a relevant factor in dysfunction.
    • Standard hemodynamic measures are insufficient for predicting left ventricular dysfunction in septic shock.