Clinical impact of visually assessed right ventricular dysfunction in patients with septic shock

Hiraiwa, Hiroaki; Kasugai, Daisuke; Ozaki, Masayuki; Goto, Yukari; Jingushi, Naruhiro; Higashi, Michiko; Nishida, Kazuki; Kondo, Toru; Fukui, Kenji; Morimoto, Ryo; Okumura, Takahiro; Matsuda, Naoyuki; Matsui, Shigeyuki; Murohara, Toyoaki

doi:10.1038/s41598-021-98397-8

Cited by 6 publications

(20 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[16,39] In the early phase of sepsis, left ventricular ejection fraction (LVEF) is not impaired; however, stroke volume is low because of insufficient cardiac preload resulting from high vascular permeability and vasodilation. [16,39,40] The heart rate may increase to compensate, although it is often insufficient to maintain adequate cardiac output. [16,39] In severe sepsis, after increased fluid loading and permeability, stroke volume can recover, particularly in survivors, while LVEF temporarily decreases, partly because of www.md-journal.com a higher LV end-diastolic volume.…”

Section: Mechanistic Changes To the Heart Underlying Septic Cardiomyo...mentioning

confidence: 99%

“…[13] A recent study demonstrated that visual assessment of RV function using echocardiography in patients with septic shock revealed that RV dysfunction was associated with lower cardiac output, pulmonary artery pressure index, and RV stroke work index. [40] Figure 1. Pathophysiology and mechanisms of septic myocardial dysfunction.…”

Section: Changes To the Heart In Sepsismentioning

confidence: 99%

“…In addition, changes to the heart in sepsis can occur in multiple ways, such as LV or RV impairment during systole or diastole, and cardiac output and oxygen delivery to the peripheral tissues may or may not be adequate. [13,39,40,44] The diagnosis of septic cardiomyopathy is usually based on echocardiography, biomarkers, and direct invasive and noninvasive measures of cardiac output. [9,44]…”

Section: Diagnosis Of Septic Cardiomyopathymentioning

confidence: 99%

“…[54] Recent studies have found that LV dysfunction is common in patients with sepsis, and while RV dysfunction is less common, it is associated with short-term mortality. [40,48,55] Similarly, RV dysfunction is associated with lethal arrhythmia and circulatory insufficiency independent of the LV systolic function. [40] Notably, the visual assessment of RV dysfunction using echocardiography can be used to identify the risk of mortality, and correlates well with hemodynamic parameters monitored using a pulmonary artery catheter.…”

Section: Echocardiographymentioning

confidence: 99%

“…[40,48,55] Similarly, RV dysfunction is associated with lethal arrhythmia and circulatory insufficiency independent of the LV systolic function. [40] Notably, the visual assessment of RV dysfunction using echocardiography can be used to identify the risk of mortality, and correlates well with hemodynamic parameters monitored using a pulmonary artery catheter. [40] In addition, echocardiographic assessments of RV function demonstrate better correlations with hemodynamic parameters than cardiac MRI assessments.…”

Section: Echocardiographymentioning

confidence: 99%

See 4 more Smart Citations

Clinical implications of septic cardiomyopathy: A narrative review

Hiraiwa,

Kasugai,

Okumura

et al. 2024

Medicine

Self Cite

View full text Add to dashboard Cite

Sepsis is caused by the body’s dysregulated response to infection, which can lead to multiorgan injury and death. Patients with sepsis may develop acute cardiac dysfunction, termed septic cardiomyopathy, which is a global but reversible dysfunction of both sides of the heart. This narrative review discusses the mechanistic changes in the heart during septic cardiomyopathy, its diagnosis, existing treatment options regarding severity and course, and emerging treatment approaches. Although no standardized definition for septic cardiomyopathy exists, it is described as a reversible myocardial dysfunction that typically resolves within 7 to 10 days. Septic cardiomyopathy is often diagnosed based on electrocardiography, cardiac magnetic resonance imaging, biomarkers, and direct invasive and noninvasive measures of cardiac output. Presently, the treatment of septic cardiomyopathy is similar to that of sepsis, primarily focusing on acute interventions. Treatments for cardiomyopathy often include angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and diuretics. However, because of profound hypotension in sepsis, many cardiomyopathy treatments are contraindicated in patients with septic cardiomyopathy. Substantial efforts have been made to study the pathophysiological mechanisms and diagnostic options; however, the lack of a uniform definition for septic cardiomyopathy is challenging for physicians when considering treatments. Another challenge for physicians is that the treatment for septic cardiomyopathy has only focused on acute intervention, whereas the treatment for other cardiomyopathies has been provided on a long-term basis. A better understanding of the underlying mechanisms of septic cardiomyopathy may contribute to the development of a unified definition of the condition and novel treatment options.

show abstract