Left ventricular function during sepsis

• Published in: Critical care medicine Vol. 17; no. 4; p. 323
• Main Authors: Artucio, H, Digenio, A, Pereyra, M
• Format: Journal Article
• Language: English
• Published: United States 01-04-1989
• Subjects: Adult; Bacterial Infections - complications; Bacterial Infections - mortality; Electrocardiography; Female; Heart - physiopathology; Humans; Male; Predictive Value of Tests; Prognosis; Risk Factors; Shock, Septic - physiopathology; Stroke Volume; Systole
• ISSN: 0090-3493
• DOI: 10.1097/00003246-198904000-00005

The prevalence and prognostic significance of left ventricular involvement in septic patients without shock was investigated. Systolic time intervals (STI) and preejection period/left ventricular ejection time ratio (PEP/LVET) were used to assess left ventricular function. Forty-nine patients, 22 of whom ultimately died, were studied. The group as a whole showed abnormal PEP/LVET ratio (0.40 +/- 0.02) that differed significantly (p less than .01) from reported normal values (0.345 +/- 0.002), demonstrating widespread left ventricular dysfunction in this population. In order to establish the prognostic significance of left ventricular impairment, the population was divided into two groups according to the PEP/LVET ratio. Group 1 (PEP/LVET less than or equal to 0.42) showed a mortality rate of 10/33 (30%), while group 2 (PEP/LVET greater than 0.42) had a significantly greater mortality (12/16 [75%], p less than .001). The test that has a sensitivity of 55%, a specificity of 85%, and a positive predictive value of 75% identifies a subset of septic patients with severe impairment of left ventricular function and high risk of dying.