| Acute left ventricular dilatation and shock-induced myocardial dysfunction. | |
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MedLine Citation:
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PMID: 19114917 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Whether cardiac ventricles can acutely dilate during septic myocardial dysfunction. DESIGN: A prospective echocardiographic study was performed to assess changes of left ventricular dimensions over time in patients with septic shock. SETTINGS: A 20-bed surgical intensive care unit of Pitié-Salpêtrière university hospital in Paris. PATIENTS: Forty-five patients were studied over the first 10 days of septic shock. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Left ventricular end-diastolic area (LVEDA), fractional area change (FAC), velocity time integral of the aortic flow, echocardiographic indices of left ventricular relaxation, and cardiac troponin I (cTnI) were measured at day 1, 2, 3, 4, 7, and 10. Three groups were defined: 29 patients without increased cTnI and cardiac impairment (group 1), eight patients with increased cTnI and left systolic ventricular dysfunction (group 2), and eight patients with increased cTnI and isolated impairment of left ventricular relaxation (group 3). At day 1, LVEDA was significantly higher in group 2 (13 +/- 3 cm/m, p < 0.05) compared with groups 1 (10 +/- 2 cm/m) and 3 (11 +/- 2 cm/m). LVEDA did not change in groups 1 and 3. In group 2, LVEDA and FAC returned within 10 days to values observed in groups 1 and 2. A significant correlation was found between aortic velocity time integral and LVDEA (r =.78, p = 0.022) and FAC (r =.89, p = 0.003) only in group 2. CONCLUSIONS: Acute and reversible left ventricular dilation accompanies septic shock-induced systolic left ventricular dysfunction. When septic myocardial abnormalities are limited to reversible impairment of left ventricular relaxation, left ventricular dimensions remain unchanged. |
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Authors:
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Bélaïd Bouhemad; Armelle Nicolas-Robin; Charlotte Arbelot; Martine Arthaud; Frédéric Féger; Jean-Jacques Rouby |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Critical care medicine Volume: 37 ISSN: 1530-0293 ISO Abbreviation: Crit. Care Med. Publication Date: 2009 Feb |
Date Detail:
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Created Date: 2009-04-01 Completed Date: 2009-05-06 Revised Date: 2009-10-29 |
Medline Journal Info:
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Nlm Unique ID: 0355501 Medline TA: Crit Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 441-7 Citation Subset: AIM; IM |
Affiliation:
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Department of Anesthesiology, Réanimation Chirurgicale Pierre Viars, Hospital Practitioner, Assistance Publique Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, University Pierre et Marie Curie Paris-6, France. belaid.bouhemad@psl.aphp.fr |
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| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Adult Aged Echocardiography Female Heart Function Tests Humans Intensive Care Units Male Middle Aged Paris Prospective Studies Shock, Septic / blood, complications, physiopathology* Troponin I / blood Ventricular Dysfunction, Left / blood, etiology, physiopathology*, ultrasonography |
| Chemical | |
Reg. No./Substance:
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0/Troponin I |
| Comments/Corrections | |
Comment In:
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Crit Care Med. 2009 Feb;37(2):743-4
[PMID:
19325364
]
Crit Care Med. 2009 Oct;37(10):2862; author reply 2862-3 [PMID: 19865025 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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