Left ventricular function during sepsis.
The prevalence and prognostic significance of left ventricular involvement in septic patients without shock was investigated. Systolic time intervals (STI) and preejection period/left ventricular ejection time ratio (PEP/LVET) were used to assess left ventricular function. Forty-nine patients, 22 of whom ultimately died, were studied. The group as a whole showed abnormal PEP/LVET ratio (0.40 +/- 0.02) that differed significantly (p less than .01) from reported normal values (0.345 +/- 0.002), demonstrating widespread left ventricular dysfunction in this population. In order to establish the prognostic significance of left ventricular impairment, the population was divided into two groups according to the PEP/LVET ratio. Group 1 (PEP/LVET less than or equal to 0.42) showed a mortality rate of 10/33 (30%), while group 2 (PEP/LVET greater than 0.42) had a significantly greater mortality (12/16 [75%], p less than .001). The test that has a sensitivity of 55%, a specificity of 85%, and a positive predictive value of 75% identifies a subset of septic patients with severe impairment of left ventricular function and high risk of dying.
Artucio
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Intensive Care Unit, University Hospital, Universidad de la República, Facultad de Medicina, Montevideo, Uruguay.
Digenio
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Pereyra
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D000328:Adult; D001424:Bacterial Infections / Q000150:complications* / Q000401:mortality; D004562:Electrocardiography; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D012772:Shock, Septic / Q000503:physiopathology; D013318:Stroke Volume; D013599:Systole