| Title |
Left ventricular systolic dysfunction during septic shock: the role of loading conditions
|
|---|---|
| Published in |
Intensive Care Medicine, February 2017
|
| DOI | 10.1007/s00134-017-4698-z |
| Pubmed ID | |
| Authors |
Florence Boissier, Keyvan Razazi, Aurélien Seemann, Alexandre Bedet, Arnaud W. Thille, Nicolas de Prost, Pascal Lim, Christian Brun-Buisson, Armand Mekontso Dessap |
| Abstract |
The clinical significance of septic myocardial dysfunction is controversial, a fact that may be explained by the influence of loading conditions. Many indices may be useful to characterize cardiac function during septic shock, but their feasibility and physiological coherence in the clinical setting are unknown. Hemodynamic and echocardiographic data with tissue Doppler and speckle tracking were prospectively recorded on the first 3 days of human septic shock. Hypokinesia, normokinesia, and hyperkinesia were defined as a left ventricular ejection fraction (LVEF) of <45, 45-60, and >60%, respectively. Twelve hemodynamic indices exploring contractility and loading conditions were assessed and analyzed. Two hundred and ninety-seven echocardiographies were performed in 132 patients. During the first 24 h (H1-24), 48 (36.4%) patients were hyperkinetic, 55 (41.7%) were normokinetic, and 29 (22.0%) patients were hypokinetic. Thirteen patients had a secondary hypokinesia absent at H1-24 but present at H25-48 or H49-72, for an overall incidence of 42 (31.8%) during the first 3 days. Despite a limited feasibility (<50%), global LV longitudinal peak systolic strain was impaired in a majority (>70%) of the patients assessed, including all those with depressed LVEF, and declined early in patients whose LVEF secondarily deteriorated. Most contractility indices were inversely correlated with afterload indices. Hyperkinetic patients exhibited the worst reduction in afterload indices. Hospital mortality was significantly higher in patients with LV hyperkinesia than in their counterparts: 30 (62.5%) vs. 35 (41.7%), p = 0.02. Speckle tracking-derived strain was reduced in the majority of patients with septic shock, revealing covert septic myocardial dysfunction, but had poor feasibility. We found an inverse correlation between most of the contractility and afterload indices. Precise evaluation of afterload is crucial for adequate interpretation of LV systolic function in this setting. |
X Demographics
The data shown below were collected from the profiles of 20 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 3 | 15% |
| Malaysia | 1 | 5% |
| Peru | 1 | 5% |
| Italy | 1 | 5% |
| Brazil | 1 | 5% |
| Mexico | 1 | 5% |
| Spain | 1 | 5% |
| Unknown | 11 | 55% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 12 | 60% |
| Practitioners (doctors, other healthcare professionals) | 4 | 20% |
| Scientists | 3 | 15% |
| Unknown | 1 | 5% |
Mendeley readers
The data shown below were compiled from readership statistics for 101 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Mexico | 1 | <1% |
| Italy | 1 | <1% |
| Unknown | 99 | 98% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 12 | 12% |
| Other | 10 | 10% |
| Student > Postgraduate | 10 | 10% |
| Professor | 9 | 9% |
| Student > Doctoral Student | 8 | 8% |
| Other | 33 | 33% |
| Unknown | 19 | 19% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 62 | 61% |
| Veterinary Science and Veterinary Medicine | 4 | 4% |
| Engineering | 3 | 3% |
| Social Sciences | 3 | 3% |
| Nursing and Health Professions | 2 | 2% |
| Other | 4 | 4% |
| Unknown | 23 | 23% |
Attention Score in Context
This research output has an Altmetric Attention Score of 12. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 05 August 2020.
All research outputs
#3,010,986
of 25,027,753 outputs
Outputs from Intensive Care Medicine
#1,982
of 5,340 outputs
Outputs of similar age
#65,577
of 465,338 outputs
Outputs of similar age from Intensive Care Medicine
#64
of 125 outputs
Altmetric has tracked 25,027,753 research outputs across all sources so far. Compared to these this one has done well and is in the 87th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 5,340 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 29.5. This one has gotten more attention than average, scoring higher than 62% of its peers.
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