Myocardial dysfunction and its prognostic utility in sepsis and septic shock
Main Article Content
Keywords
Echocardiography, Septic, Sepsis, Shock, Mortality, Heart Diseases
Abstract
Background: Sepsis is a potentially mortal infection which is related to multiple organ dysfunction; it has a high morbidity and mortality. Myocardial dysfunction is frequent in sepsis and it is related to unfavorable outcomes.
Objective: To describe by transthoracic echocardiography the clinical distribution of myocardial dysfunction in sepsis and septic shock and estimate its prognostic utility.
Material and methods: Cross-sectional study based on a multi-centric prospective cohort study in 4 reference centers in Bucaramanga, Colombia, and its metropolitan area. 271 patients with sepsis and septic shock were included; they underwent standard transthoracic echocardiography and a 30-day follow-up.
Results: There was no difference in the left ventricular ejection fraction (p = 0.061) between survivors and nonsurvivors. 51 patients (48.71%) had grade I diastolic dysfunction, 48 patients (14.52%) had grade II dysfunction and 21 patients (36.75%) had grade III diastolic dysfunction. Mortality was higher in patients with grade I diastolic dysfunction when compared to those with grade II dysfunction (p = 0.023).
Conclusions: The higher mortality in grade I diastolic dysfunction suggests that patients with low filling pressures have worst outcomes. On the other hand, left ventricular ejection fraction per se is not associated with a higher mortality in sepsis.
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