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the prognostic value of left ventricular systolic function measured by tissue doppler imaging in septic shock左心室收缩功能的预后价值衡量组织多普勒成像在感染性休克
Weng et al. Critical Care 2012, 16:R71
/content/16/3/R71
RESEARCH Open Access
The prognostic value of left ventricular systolic
function measured by tissue Doppler imaging in
septic shock
2† 1*† 2 2 1 2 2
Li Weng , Yong-tai Liu , Bin Du , Jian-fang Zhou , Xiao-xiao Guo , Jin-min Peng , Xiao-yun Hu ,
Shu-yang Zhang1, Quan Fang1 and Wen-ling Zhu1
Abstract
Introduction: Left ventricular (LV) dysfunction is common in septic shock. Its association with the clinical outcome
is still controversial. Tissue Doppler imaging (TDI) is a useful tool to quantify LV function; however, little knowledge
is available about the prognostic value of these TDI variables in septic shock. Therefore, we performed this
prospective study to determine the role of TDI variables in septic shock.
Methods: Patients with septic shock in a medical intensive care unit were studied with transthoracic
echocardiography with TDI within 24 hours after the onset of septic shock. Baseline clinical, laboratory, and
echocardiographic variables were prospectively collected. Independent predictors of 90-day mortality were
analyzed with the Cox regression model.
Results: During a 20-month period, 61 patients were enrolled in the study. The 90-day mortality rate was 39%; the
mean APACHE IV score was 84 (68 to 97). Compared with survivors, nonsurvivors exhibited significantly higher
peak systolic velocity measured at the mitral annulus (Sa) (11.0 (9.1 to 12.5) versus 7.8 (5.5 to 9.0) cm/sec; P
0.0001), lower PaO2/FiO2 (123 (83 to 187) versus 186 (142 to 269) mm Hg; P = 0.002], higher heart rate (120 (90 to
140) versus 103 (90 to 114) beats/min; P = 0.004], and ahigher dose of norepinephrine (0.6 (0.2 to 1.0) versus 0.3
(0.2 to 0.5) μ
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