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Left ventricular torsion abnormalities in septic shock and corrective effect of volume loading: a pilot study.
MedLine Citation:
PMID:  24267806     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: Ventricular torsion is an important component of cardiac function. The effect of septic shock on left ventricular torsion is not known. Because torsion is influenced by changes in preload, we compared the effect of fluid loading on left ventricular torsion in septic shock with the response in matched healthy control subjects.
METHODS: We assessed left ventricular torsion parameters using transthoracic echocardiography in 11 patients during early septic shock and in 11 age- and sex-matched healthy volunteers before and after rapid volume loading with 250 mL of a Ringer's lactate solution.
RESULTS: Peak torsion and peak apical rotation were reduced in septic shock (10.2 ± 5.2° and 5.6 ± 5.4°) compared with healthy volunteers (16.3 ± 4.5° and 9.6 ± 1.5°; P = 0.009 and P = 0.006 respectively). Basal rotation was delayed and diastolic untwisting velocity reached its maximum later during diastole in septic shock patients than in healthy volunteers (104 ± 16% vs 111 ± 14% and 13 ± 5% vs 21 ± 10%; P = 0.03 and P = 0.034, respectively). Fluid challenge increased peak torsion in both groups (septic shock, 10.2 ± 5.3° vs 12.6 ± 3.9°; healthy volunteers, 16.3 ± 4.5° vs 18.1 ± 6°; P = 0.01). Fluid challenge increased left ventricular stroke volume in septic shock patients (P = 0.003).
CONCLUSIONS: Compared with healthy volunteers, left ventricular torsion is impaired in septic shock patients. Fluid loading attenuates torsion abnormalities in parallel with increasing stroke volume. Reduced torsional motion might constitute a relevant component of septic cardiomyopathy, a notion that merits further testing in larger populations.
Authors:
Stefan Bloechlinger; David Berger; Jürg Bryner; Jan Wiegand; Martin W Dünser; Jukka Takala
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Publication Detail:
Type:  Journal Article     Date:  2013-10-10
Journal Detail:
Title:  The Canadian journal of cardiology     Volume:  29     ISSN:  1916-7075     ISO Abbreviation:  Can J Cardiol     Publication Date:  2013 Dec 
Date Detail:
Created Date:  2013-11-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8510280     Medline TA:  Can J Cardiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  1665-71     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Intensive Care Medicine, Bern University Hospital (Inselspital) and University of Bern, Bern, Switzerland; Department of Cardiology, Bern University Hospital (Inselspital) and University of Bern, Bern, Switzerland. Electronic address: Stefan.Bloechlinger@insel.ch.
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