Association between right ventricle dysfunction and poor outcome in patients with septic shock

Kim, June-Sung; Kim, Youn-Jung; Kim, Muyeol; Ryoo, Seung Mok; Kim, Won Young

doi:10.1136/heartjnl-2020-316889

Cited by 28 publications

(36 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Moreover, the 28-day mortality of SIMD patients was also elevated as compared to the NSIMD subjects; although this difference was not significant, it might be related to the small sample size. These discoveries were in line with previous studies, suggesting that the myocardial dysfunction will worsen the prognosis of sepsis or septic patients ( Frencken et al., 2018 ; Kim et al., 2020 ). According to this finding, we should pay more attention to the frequent complications of sepsis.…”

Section: Discussionsupporting

confidence: 91%

“…SIMD was diagnosed established by both hs-cTnI levels and bedside transthoracic echocardiography (TTE). Specifically, hs-cTnI levels were monitored, and TTE was performed in the first 24 h of admission to ICU and if the parameter is higher than 0.04 ng/ml ( Kim et al., 2020 ) (a cutoff value that represents the 99th percentile reported in the healthy population). Meanwhile, an echocardiogram confirmed that the left ventricular ejection fraction (LVEF) <50% and/or ≥10% in the patient’s initial EF assessed on admission ( Jeong et al., 2018 ).…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Association Between Gut Dysbiosis and Sepsis-Induced Myocardial Dysfunction in Patients With Sepsis or Septic Shock

Chen

Zhang

et al. 2022

Front. Cell. Infect. Microbiol.

View full text Add to dashboard Cite

ObjectiveSepsis-induced myocardial dysfunction (SIMD) seriously affects the evolution and prognosis of the sepsis patient. The gut microbiota has been confirmed to play an important role in sepsis or cardiovascular diseases, but the changes and roles of the gut microbiota in SIMD have not been reported yet. This study aims to assess the compositions of the gut microbiota in sepsis or septic patients with or without myocardial injury and to find the relationship between the gut microbiota and SIMD.MethodsThe prospective, observational, and 1:1 matched case–control study was conducted to observe gut microbiota profiles from patients with SIMD (n = 18) and matched non-SIMD (NSIMD) patients (n = 18) by 16S rRNA gene sequencing. Then the relationship between the relative abundance of microbial taxa and clinical indicators and clinical outcomes related to SIMD was analyzed. The receiver operating characteristic (ROC) curves were used to evaluate the predictive efficiencies of the varied gut microbiota to SIMD.ResultsSIMD was associated with poor outcomes in sepsis patients. The beta-diversity of the gut microbiota was significantly different between the SIMD patients and NSIMD subjects. The gut microbiota profiles in different levels significantly differed between the two groups. Additionally, the abundance of some microbes (Klebsiella variicola, Enterobacteriaceae, and Bacteroides vulgatus) was correlated with clinical indicators and clinical outcomes. Notably, ROC analysis indicated that K. variicola may be a potential biomarker of SIMD.ConclusionOur study indicates that SIMD patients may have a particular gut microbiota signature and that the gut microbiota might be a potential diagnostic marker for evaluating the risk of developing SIMD.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Methodsmentioning

confidence: 99%

Association Between Gut Dysbiosis and Sepsis-Induced Myocardial Dysfunction in Patients With Sepsis or Septic Shock

Chen

Zhang

et al. 2022

Front. Cell. Infect. Microbiol.

View full text Add to dashboard Cite

show abstract

“…RV dysfunction is common in severe sepsis/septic shock. Its prevalence ranges from 40% to 60% at admission but significantly increase when the enrollment lasts up to 72 h. RV dysfunction correlated with longer stay in ICU, and independently associated with higher risk of both early and long-term mortality [ 96 , 97 , 98 ]. Nevertheless, conflicting results exist and the complex geometry of RV—alongside the tight ventricular interdependence—raises many questions.…”

Section: Clinical Diagnosismentioning

confidence: 99%

Septic Cardiomyopathy: From Pathophysiology to the Clinical Setting

Carbone

Liberale

Preda

et al. 2022

Cells

View full text Add to dashboard Cite

The onset of cardiomyopathy is a common feature in sepsis, with relevant effects on its pathophysiology and clinical care. Septic cardiomyopathy is characterized by reduced left ventricular (LV) contractility eventually associated with LV dilatation with or without right ventricle failure. Unfortunately, such a wide range of ultrasonographic findings does not reflect a deep comprehension of sepsis-induced cardiomyopathy, but rather a lack of consensus about its definition. Several echocardiographic parameters intrinsically depend on loading conditions (both preload and afterload) so that it may be challenging to discriminate which is primitive and which is induced by hemodynamic perturbances. Here, we explore the state of the art in sepsis-related cardiomyopathy. We focus on the shortcomings in its definition and point out how cardiac performance dynamically changes in response to different hemodynamic clusters. A special attention is also given to update the knowledge about molecular mechanisms leading to myocardial dysfunction and that recall those of myocardial hibernation. Ultimately, the aim of this review is to highlight the unsolved issue in the field of sepsis-induced cardiomyopathy as their implementation would lead to improve risk stratification and clinical care.

show abstract

“…Most studies detected myocardial dysfunction with echocardiography, and one did so with afterload-related cardiac performance [ 19 ]. Among the studies using an echocardiogram, 17 defined SIC with LV dysfunction [ 8 , 10 , 20 – 25 , 27 – 32 , 34 , 35 , 38 ], and seven included RV dysfunction as well [ 18 , 22 , 26 , 33 , 36 – 38 ], Among the 17 LV dysfunction studies, 15 showed LVSD, and 12 of them defined abnormal LVSD as LVEF < 50%. One study described LVSD as pre-ejection period and LV ejection time ratio greater than 42% [ 21 ], and another presented LVSD with the ratio of fractional area change smaller than 50% [ 10 ].…”

Section: Resultsmentioning

confidence: 99%

Association of sepsis-induced cardiomyopathy and mortality: a systematic review and meta-analysis

Lin

Lee

Toh

et al. 2022

Ann. Intensive Care

View full text Add to dashboard Cite

Background The implication of sepsis-induced cardiomyopathy (SIC) to prognosis is controversial, and its association with mortality at different stages remains unclear. We conducted a systematic review and meta-analysis to understand the association between SIC and mortality in septic patients. Methods We searched and appraised observational studies regarding the mortality related to SIC among septic patients in PubMed and Embase from inception until 8 July 2021. Outcomes comprised in-hospital and 1-month mortality. We adopted the random-effects model to examine the mortality risk ratio in patients with and without SIC. Meta-regression, subgroup, and sensitivity analyses were applied to examine the outcome’s heterogeneity. Results Our results, including 20 studies and 4,410 septic patients, demonstrated that SIC was non-statistically associated with increased in-hospital mortality, compared to non-SIC (RR 1.28, [0.96–1.71]; p = 0.09), but the association was statistically significant in patients with the hospital stay lengths longer than 10 days (RR 1.40, [1.02–1.93]; p = 0.04). Besides, SIC was significantly associated with a higher risk of 1-month mortality (RR 1.47, [1.17–1.86]; p < 0.01). Among SIC patients, right ventricular dysfunction was significantly associated with increased 1-month mortality (RR 1.72, [1.27–2.34]; p < 0.01), while left ventricular dysfunction was not (RR 1.33, [0.87–2.02]; p = 0.18). Conclusions With higher in-hospital mortality in those hospitalized longer than 10 days and 1-month mortality, our findings imply that SIC might continue influencing the host’s system even after recovery from cardiomyopathy. Besides, right ventricular dysfunction might play a crucial role in SIC-related mortality, and timely biventricular assessment is vital in managing septic patients.

show abstract

Association between right ventricle dysfunction and poor outcome in patients with septic shock

Cited by 28 publications

References 30 publications

Association Between Gut Dysbiosis and Sepsis-Induced Myocardial Dysfunction in Patients With Sepsis or Septic Shock

Association Between Gut Dysbiosis and Sepsis-Induced Myocardial Dysfunction in Patients With Sepsis or Septic Shock

Septic Cardiomyopathy: From Pathophysiology to the Clinical Setting

Association of sepsis-induced cardiomyopathy and mortality: a systematic review and meta-analysis

Contact Info

Product

Resources

About