Korean Circulation Journal

  • 제53권12호
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  • Pages.813-825
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  • 2023
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  • 1738-5520(pISSN)
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  • 1738-5555(eISSN)
대한심장학회 (The Korean Society of Cardiology)
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Seven-day and In-hospital Mortality According to Left and Right Ventricular Dysfunction in Patients With Septic Shock

  • Sua Kim (Department of Critical Care Medicine, Korea University Ansan Hospital, Korea University College of Medicine) ;
  • Hyeri Seok (Division of Infectious Disease, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine) ;
  • Beong Ki Kim (Division of Pulmonology, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine) ;
  • Yu Jin Kim (Division of Pulmonology, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine) ;
  • Seung Heon Lee (Division of Pulmonology, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine) ;
  • Je Hyeong Kim (Department of Critical Care Medicine, Korea University Ansan Hospital, Korea University College of Medicine) ;
  • Yong-Hyun Kim (Division of Cardiology, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine)
  • 투고 : 2023.03.03
  • 심사 : 2023.07.11
  • 발행 : 2023.12.01
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초록

Background and Objectives: The prognostic implications of septic cardiomyopathy have not been clearly demonstrated. We evaluated serial changes in left ventricular (LV) and right ventricular (RV) function in patients with septic shock and their prognostic value on 7-day and in-hospital mortality. Methods: Transthoracic echocardiography was performed within 48 hours of the diagnosis of septic shock and 7 days after the initial evaluation. In addition to traditional echocardiographic parameters, LV and RV function was evaluated using global longitudinal strain (GLS), and tricuspid annular plane systolic excursion (TAPSE). Results: A total of 162 patients (men, 83, 51.5%; 70.7±13.4 years; Acute Physiology and Chronic Health Evaluation [APACHE] II, 30.6±9.2) were enrolled. Initial GLS and TAPSE were -14.9±5.2% and 16.9±5.5 mm, and improved in the follow-up evaluation (GLS, -17.6±4.9%; TAPSE, 19.2±5.4 mm). Seven-day and in-hospital mortality were 24 (14.9%) and 64 (39.8%). Seven-day mortality was significantly associated with initial GLS >-16% (odds ratio [OR], 14.066, 95% confidence interval [CI], 1.178-167.969, p=0.037) and APACHE II score (OR, 1.196, 95% CI, 1.047-1.365, p=0.008). The in-hospital mortality of 7-day survivors was associated with follow-up TAPSE <16 mm (OR, 10.109, 95% CI, 1.640-62.322, p=0.013) and Sequential Organ Failure Assessment score (OR, 1.340, 95% CI, 1.078-1.667, p=0.008). GLS was not associated with in-hospital mortality of 7-day survivors. Conclusions: Fluctuation of both ventricular function was common in septic shock. Seven-day mortality of patients with septic shock was related to GLS, whereas in-hospital mortality of 7-day survivors was related to TAPSE, not to GLS.

키워드

과제정보

We would like to acknowledge the contribution of the sonographers who performed the echocardiographic evaluation of the patients; Seon-ju Woo, Hyeon-mi Kim, and Hye-joo Kim.

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