| Left ventricular performance in septic shock: reversible segmental and global abnormalities. | |
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MedLine Citation:
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PMID: 4025116 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Left ventricular dysfunction has been implicated in the pathogenesis of septic shock, but little is known about its natural history, cause, and prognostic significance. Left ventricular performance was assessed by serial radionuclide and hemodynamic studies in 35 patients with culture-proven septic shock. The mean age (+/- S.D.) of the group was 64 +/- 18 years; 16 of the subjects were women, and 15 had antecedent heart disease. On the first study, the left ventricular stroke work index was depressed in 33 (94%) patients, and nineteen (54%) had a left ventricular ejection fraction less than 0.48. Twenty-two (63%) of the patients had segmental and four had generalized wall motion abnormalities. Conventional hemodynamic parameters were of no value in predicting the patients who had a depressed left ventricular ejection fraction or segmental abnormalities. Patients with underlying heart disease had a much higher frequency (87%) of segmental dysfunction than those without underlying heart disease (45%; p = 0.016), but no differences were noted in the left ventricular ejection fraction or left ventricular stroke work index of these two groups. Segmental abnormalities and low ejection fractions were seen more often in patients with a large left ventricular end-diastolic volume index. Only five subjects had a systemic vascular resistance index greater than 2580 dynes X sec X cm-5 per m2, and the correlation between systemic vascular resistance index and left ventricular ejection fraction was poor. No difference was found in the mean coronary perfusion pressure of those with segmental abnormalities and those with normal wall motion.(ABSTRACT TRUNCATED AT 250 WORDS) |
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Authors:
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A G Ellrodt; M S Riedinger; A Kimchi; D S Berman; J Maddahi; H J Swan; G H Murata |
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Publication Detail:
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Type: Journal Article; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: American heart journal Volume: 110 ISSN: 0002-8703 ISO Abbreviation: Am. Heart J. Publication Date: 1985 Aug |
Date Detail:
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Created Date: 1985-09-09 Completed Date: 1985-09-09 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0370465 Medline TA: Am Heart J Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 402-9 Citation Subset: AIM; IM |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Blood Pressure Coronary Vessels Female Heart / physiopathology* Heart Diseases / physiopathology Heart Ventricles / physiopathology, radionuclide imaging Hemodynamics Humans Male Middle Aged Prognosis Shock, Septic / drug therapy, mortality, physiopathology* Stroke Volume Vasoconstrictor Agents / therapeutic use |
| Grant Support | |
ID/Acronym/Agency:
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05468//PHS HHS |
| Chemical | |
Reg. No./Substance:
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0/Vasoconstrictor Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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