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Left Ventricular Systolic Longitudinal Function as Predictor of Outcome in Patients With Sepsis.

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Left Ventricular Systolic Longitudinal Function as Predictor of Outcome in Patients With Sepsis.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Palmieri, Vittorio Innocenti, Francesca Guzzo, Aurelia Guerrini, Elisa Vignaroli, Damiano Pini, Riccardo
Description	Author Affiliation: Palmieri V ( From the Cardiology Unit, Department of Heart and Vessels, SG Moscati National Hospital, Avellino, Italy (V.P.)); Innocenti F ( From the Cardiology Unit, Department of Heart and Vessels, SG Moscati National Hospital, Avellino, Italy (V.P.)); Guzzo A ( From the Cardiology Unit, Department of Heart and Vessels, SG Moscati National Hospital, Avellino, Italy (V.P.)); Guerrini E ( From the Cardiology Unit, Department of Heart and Vessels, SG Moscati National Hospital, Avellino, Italy (V.P.)); Vignaroli D ( From the Cardiology Unit, Department of Heart and Vessels, SG Moscati National Hospital, Avellino, Italy (V.P.)); Pini R ( From the Cardiology Unit, Department of Heart and Vessels, SG Moscati National Hospital, Avellino, Italy (V.P.))
Abstract	BACKGROUND: In sepsis, whether the assessment of left ventricular global longitudinal systolic strain (GLS) is feasible and prognostically relevant remains controversial. METHODS AND RESULTS: Consecutive patients admitted to a high-dependency observational unit with sepsis or septic shock were evaluated. Left ventricular ejection fraction (EF) by planimetry and peak GLS by 2D speckle tracking were available at admission in 115 of 149 (77%) patients. Compared with patients included in the study, those excluded (n=34, 23%) showed higher proportion of chronic obstructive pulmonary disease (P<0.01), but with comparable clinical characteristics and mortality rates. GLS showed lowest variability for low EF and highest for higher EF. By day-28 follow-up, all-cause mortality was 30% (n=34 and n=19 within 7 days from hospitalization). GLS and EF were both more abnormal in deceased than in those alive by day-28 follow-up (both P<0.05, findings consistent using day-7 follow-up data). GLS showed a borderline relationship with mortality by day-28 follow-up (hazard ratio 1.16/%, P=0.05), whereas EF did not (hazard ratio 0.99/%, P=0.63) accounting for age; the lack of association of all-cause mortality with EF was consistent at day-7 follow-up (hazard ratio 0.94/%, P=0.9), whereas more abnormal GLS correlated significantly with higher mortality rate (hazard ratio 1.30/%, P=0.03) independent to age. CONCLUSIONS: In patients with sepsis assisted in a high-dependency observational unit, feasibility of assessments of left ventricular EF and GLS within 24 h from the hospitalization was acceptable and EF showed no prognostic relevance, whereas GLS showed a correlation with mortality rate potentially relevant in shorter more than in longer follow-ups.
File Format	HTM / HTML
ISSN	19419651
e-ISSN	19420080
Journal	Circulation: Cardiovascular Imaging
Issue Number	11
Volume Number	8
Language	English
Publisher	American Heart Association
Publisher Date	2015-11-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Diagnostic Imaging Discipline Cardiology Echocardiography Sepsis Complications Ventricular Dysfunction, Left Etiology Image Interpretation, Computer-assisted Prognosis Pulmonary Disease, Chronic Obstructive Risk Factors Mortality Stroke Volume
Content Type	Text
Resource Type	Article
Subject	Radiology, Nuclear Medicine and Imaging Cardiology and Cardiovascular Medicine

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