title: Prognosis of left ventricular systolic dysfunction in septic shock patients.
abstract: BACKGROUND
  The prognosis of myocardial dysfunction in critically ill patients with sepsis and its association with mortality is controversial. We aim to determine the significance of left ventricular systolic dysfunction in septic shock patients and their associated outcome.
  
  
  METHODS
  A prospective, single center, observational study was carried out at an intensive care unit of a tertiary care hospital. A total of 66 patients diagnosed with septic shock were enrolled in the study from September 2010 to June 2012. The 2D echocardiography was performed for all the patients. Ejection fraction <50% was the diagnosing parameter for the patients with systolic dysfunction in septic shock. Acute Physiology and Chronic Health Evaluation III (APACHE III) score was calculated.
  
  
  RESULTS
  The mean age of patients were found to be 53.71 ± 16.76 years. The mortality rate was found to be 48.48% and among them 43.75% patients had ejection fraction <50%. Non-survivors exhibited significantly lower mean blood pressure (74.19 ± 10.28 versus 80.59 ± 11.31; p = 0.008), lower ejection fraction (52.59 ± 16.37 versus 62.56 ± 8.31; p = 0.029) and higher APACHE III score (89.34 ± 15.41 versus 70.65 ± 13.27; p <0.001). The receiver operating characteristic curves APACHE III score (area under curve = 0.830) and ejection fraction (area under curve = 0.656) were used to predict the mortality in septic patients.
  
  
  CONCLUSIONS
  Low ejection fraction, a marker to measure left ventricular systolic dysfunction is a predictor of mortality in septic shock patients. However, more research is needed to confirm the findings.
authors.affiliation: Professor, Department of Medicine, Kasturba Medical College and Hospital , Manipal, Karnataka, India .
authors.forename: M Mukhyaprana
authors.initials: MM
authors.lastname: Prabhu
authors.affiliation: Junior Resident, Department of Medicine, Kasturba Medical College & Hospital , Manipal, Karnataka, India .
authors.forename: Suresh Kumar
authors.initials: SK
authors.lastname: Yalakala
authors.affiliation: Professor, Department of Cardiology, Kasturba Medical College & Hospital , Manipal, Karnataka, India .
authors.forename: Ranjan
authors.initials: R
authors.lastname: Shetty
authors.affiliation: Senior Manager - Clinical Research & Medical Writing, Department of Clinical Trials, Sahajanand Medical Technologies Pvt. Ltd. , Surat, Gujarat, India .
authors.forename: Ashok
authors.initials: A
authors.lastname: Thakkar
authors.affiliation: Trainee Medical Writer, Department of Clinical Trials, Sahajanand Medical Technologies Pvt. Ltd. , Surat, Gujarat, India .
authors.forename: Tulsee
authors.initials: T
authors.lastname: Sitapara
keywords: Echocardiography; Ejection fraction; Mortality