Associations among left ventricular systolic function, tachycardia, and cardiac preload in septic patients


In sepsis, tachycardia may indicate low preload, adrenergic stimulation, or both. Adrenergic overstimulation is associated with septic cardiomyopathy.

We sought to determine whether tachycardia was associated with left ventricular longitudinal strain, a measure of cardiac dysfunction. We hypothesized an association would primarily exist in patients with high preload.

Methods: We prospectively observed septic patients admitted to three study ICUs, who underwent early transthoracic echocardiography.

We measured longitudinal strain using speckle tracking echocardiography and estimated preload status with an echocardiographic surrogate (E/e?). We assessed correlation between strain and heart rate in patients with low preload (E/e?<8), intermediate preload (E/e?814), and high preload (E/e?>14), adjusting for disease severity and vasopressor dependence.

Results: We studied 452 patients, of whom 298 had both measurable strain and preload.

Abnormal strain (defined as >?17%) was present in 54%. Patients with abnormal strain had higher heart rates (100 vs.

93 beat/min, p=0.001). After adjusting for vasopressor dependence, disease severity, and cardiac preload, we observed an association between heart rate and longitudinal strain (?=0.05, p=0.003).

This association persisted among patients with high preload (?=0.07, p=0.016) and in patients with shock (?=0.07, p=0.01), but was absent in patients with low or intermediate preload and those not in shock.

Conclusions: Tachycardia is associated with abnormal left ventricular strain in septic patients with high preload. This association was not apparent in patients with low or intermediate preload.



Published on: 2017-02-20

Made available by EUPB via SpringerOpen / BioMedCentral. Please make sure to read our disclaimer prior to contacting 7thSpace Interactive. To contact our editors, visit our online helpdesk. To submit your press release click here. The full research and author details are available at http://www.annalsofintensivecare.com/content/7/1/17

Discussions




Custom Search



Username
Password










© 2017 7thSpace Interactive
All Rights Reserved - About | Disclaimer | Helpdesk