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

Abstract Background 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′ 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 (β = 0.05, p = 0.003). This association persisted among patients with high preload (β = 0.07, p = 0.016) and in patients with shock (β = 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.

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PID https://www.doi.org/10.6084/m9.figshare.c.3819313.v1
PID https://www.doi.org/10.6084/m9.figshare.c.3819313
URL https://dx.doi.org/10.6084/m9.figshare.c.3819313.v1
URL https://dx.doi.org/10.6084/m9.figshare.c.3819313
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Author Michael Lanspa
Author Sajid Shahul
Author Andrew Hersh
Author Emily Wilson
Author Troy Olsen
Author Eliotte Hirshberg
Author Colin Grissom
Author Samuel Brown
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Publication Date 2017-07-06
Publisher Figshare
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keyword FOS: Health sciences
keyword mesheuropmc.musculoskeletal, neural, and ocular physiology
keyword FOS: Biological sciences
keyword mesheuropmc.digestive, oral, and skin physiology
system:type dataset
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Source https://science-innovation-policy.openaire.eu/search/dataset?datasetId=dedup_wf_001::5e7ce5c8fa27f6d24fc92c7901b11604
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Last Updated 14 January 2021, 13:05 (CET)
Created 14 January 2021, 13:05 (CET)