Early diastolic dysfunction is associated with intensive care unit mortality in cancer patients presenting with septic shock

Abstract

Early diastolic dysfunction is a strong and independent predictor of mortality in cancer patients presenting with septic shock. It is not associated with exposure to cardiotoxic drugs. Further studies incorporating monitoring of diastolic function and therapeutic interventions improving cardiac relaxation need to be evaluated in cancer patients presenting with septic shock.

Diastolic dysfunction and mortality in septic patients: a systematic review and meta-analysis

“…Abstracts were then appraised against inclusion criteria and 23 full-text articles were retrieved for further analysis. Finally, we identified ten studies as suitable for the meta-analysis; however, only seven articles were included for quantitative analysis [12,13,[23][24][25][26][27]. One study was excluded because it did not use TDI criteria for assessing DD, was published in 1997 and used the pulmonary vein flow pattern (S/D ratio) as criteria for defining DD [28].…”

“…From the qualitative analysis we selected seven observational studies [12,13,[23][24][25][26][27] assessing DD with TDI criteria and including 647 patients with sepsis reported outcomes of patients with DD. Only one study used transoesophageal echocardiography [23].…”

“…Six of the included studies reported also rates of mechanical ventilation, ranging from 49 to 100 % of the patient population [12,[23][24][25][26][27]. No studies provide a breakdown of age and/or mechanical ventilation according to the diastolic function ( Table 2).…”

“…Five studies [12,13,23,24,26] also reported data on the presence of SD, with an overall incidence of 29.6 % (n = 172/581), varying from 23.3 to 54.2 % (Supplemental Digital Content-Appendix 2). One study reported data on SD and mortality, but was excluded since normal and mildly impaired systolic function (EF \ 45 %) were included in the same group [25].…”

“…In the seven studies included in the meta-analysis of primary outcome [12,13,[23][24][25][26][27], mortality at longest follow-up was significantly higher in patients with DD vs patients with normal diastolic function (RR 1.82, 95 % CI 1.12-2.97, p = 0.02; Fig. 2a).…”