Document Detail

Ventricular dilation is associated with improved cardiovascular performance and survival in sepsis.
MedLine Citation:
PMID:  20651022     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Myocardial dysfunction in sepsis may be associated with changes in left ventricular (LV) size. The goal of this study was to evaluate the impact of myocardial dysfunction and changes in LV diameter on hemodynamics and survival in a murine model of sepsis. METHODS: C57Bl/6 mice (N = 30) were used. Septic mice (n = 24) had cecal ligation and puncture (CLP) followed by fluid and antibiotic resuscitation and control mice (n = 6) received sham ligation. Echocardiography with a 30-mHz probe was performed at baseline and at frequent predefined time points after CLP. Stroke volume (SV), cardiac output (CO), LV internal diameter in diastole (LVIDd), and fractional shortening (FS) were measured. LV dilation was prospectively defined as an increase in LVIDd ≥ 5% from baseline values. Septic animals were classified as dilators or nondilators. RESULTS: Among septic animals, 37% were dilators and 63% were nondilators. After CLP, SV and CO decreased early in both groups. With resuscitation, SV and CO improved to a greater extent in dilators than nondilators (for SV, 46.0 ± 8.2 vs 36.1 ± 12.7 μL at 24 h, P = .05; for CO, 20.4 ± 4.8 vs 14.8 ± 6.7 mL/min, P = .04). Survival at 72 h was significantly improved in dilators compared with nondilators (88% vs 40%, P = .01). CONCLUSIONS: In a clinically relevant murine model of sepsis, animals with LV dilation had better cardiovascular performance and increased survival. Our results suggest that LV dilation is associated with improved SV and CO, a pattern resulting in greatly improved survival. These studies highlight the importance of diastolic function in septic shock.
Sergio L Zanotti Cavazzoni; Massimiliano Guglielmi; Joseph E Parrillo; Tracy Walker; R Phillip Dellinger; Steven M Hollenberg
Publication Detail:
Type:  Journal Article     Date:  2010-07-22
Journal Detail:
Title:  Chest     Volume:  138     ISSN:  1931-3543     ISO Abbreviation:  Chest     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-06     Completed Date:  2010-10-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  848-55     Citation Subset:  AIM; IM    
Division of Critical Care Medicine, Cooper University Hospital, Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, Camden, NJ 08103, USA.
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MeSH Terms
Analysis of Variance
Dilatation, Pathologic / physiopathology,  ultrasonography
Disease Models, Animal
Heart Ventricles / physiopathology*,  ultrasonography
Mice, Inbred C57BL
Sepsis / physiopathology*
Stroke Volume
Survival Rate

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