Mitral annular plane systolic excursion for assessing left ventricular systolic dysfunction in patients with septic shock

Brault, C.; Zerbib, Yoann; Mercado, Pablo; Michaud, Audrey; Tribouilloy, Christophe; Maizel, Julien; Slama, Michel

doi:10.1016/j.bjao.2023.100220

Cited by 2 publications

(1 citation statement)

References 36 publications

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“…Although not many studies have been published so far investigating the role of MAPSE in the assessment of systolic function in septic cardiomyopathy, Brault et al . [ 50 ] described in their work a positive correlation of septal MAPSE

1.2 cm with LV systolic dysfunction. Likewise, MAPSE was shown to be an independent predictor of intra-hospital mortality in pediatric patients with sepsis.…”

Section: Diagnostic Possibilitiesmentioning

confidence: 99%

Septic Cardiomyopathy

Lukić,

Mihić,

Varžić

et al. 2024

Rev. Cardiovasc. Med.

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Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection. Sepsis-induced myocardial dysfunction represents reversible myocardial dysfunction which ultimately results in left ventricular dilatation or both, with consequent loss of contractility. Studies on septic cardiomyopathy report a wide range of prevalence ranging from 10% to 70%. Myocardial damage occurs as a result of weakened myocardial circulation, direct myocardial depression, and mitochondrial dysfunction. Mitochondrial dysfunction is the leading problem in the development of septic cardiomyopathy and includes oxidative phosphorylation, production of reactive oxygen radicals, reprogramming of energy metabolism, and mitophagy. Echocardiography provides several possibilities for the diagnosis of septic cardiomyopathy. Systolic and diastolic dysfunction of left ventricular is present in 50–60% of patients with sepsis. Right ventricular dysfunction is present in 50–55% of cases, while isolated right ventricular dysfunction is present in 47% of cases. Left ventricle (LV) diastolic dysfunction is very common in septic shock, and it represents an early biomarker, it has prognostic significance. Right ventricular dysfunction associated with sepsis patients with worse early prognosis. Global longitudinal stress and magnetic resonance imaging (MRI) of the heart are sufficiently sensitive methods, but at the same time MRI of the heart is difficult to access in intensive care units, especially when dealing with critically ill patients. Previous research has identified two biomarkers as a result of the integrated mitochondrial response to stress, and these are fibroblast growth factor-21 (FGF-21) and growth differentiation factor-15 (GDF-15). Both of the mentioned biomarkers can be easily quantified in serum or plasma, but they are difficult to be specific in patients with multiple comorbidities. Mitochondrial dysfunction is also associated with reduced levels of miRNA (microRNA), some research showed significance of miRNA in sepsis-induced myocardial dysfunction, but further research is needed to determine the clinical significance of these molecules in septic cardiomyopathy. Therapeutic options in the treatment of septic cardiomyopathy are not specific, and include the optimization of hemodynamic parameters and the use of antibiotic thera-pies with targeted action. Future research aims to find mechanisms of targeted action on the initial mechanisms of the development of septic cardiomyopathy.

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1.2 cm with LV systolic dysfunction. Likewise, MAPSE was shown to be an independent predictor of intra-hospital mortality in pediatric patients with sepsis.…”

Section: Diagnostic Possibilitiesmentioning

confidence: 99%

Septic Cardiomyopathy

Lukić,

Mihić,

Varžić

et al. 2024

Rev. Cardiovasc. Med.

View full text Add to dashboard Cite

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Association between left ventricular systolic function parameters and myocardial injury, organ failure and mortality in patients with septic shock

Blixt,

Nguyen,

Cholley

et al. 2024

Ann. Intensive Care

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Background Left ventricular ejection fraction (LVEF) is inconsistently associated with poor outcomes in patients with sepsis. Newer parameters such as LV longitudinal strain (LVLS), mitral annular plane systolic excursion (MAPSE) and LV longitudinal wall fractional shortening (LV-LWFS) may be more sensitive indicators of LV dysfunction, but are sparsely investigated. Our objective was to evaluate the association between five traditional and novel echocardiographic parameters of LV systolic function (LVEF, peak tissue Doppler velocity at the mitral valve (s´), LVLS, MAPSE and LV-LWFS) and outcomes in patients admitted to the Intensive Care Unit (ICU) with septic shock. Methods A total of 152 patients admitted to the ICU with septic shock from two data repositories were included. Transthoracic echocardiograms were performed within 24 h of ICU admission. The primary outcome was myocardial injury, defined as high-sensitivity troponin T ≥ 45 ng/L on ICU admission. Secondary outcomes were organ support-free days (OSFD) and 30-day mortality. We also tested for the prognostic value of the systolic function parameters using multivariable analysis. Results LVLS, MAPSE and LV-LWFS, but not LVEF and s´, differed between patients with and without myocardial injury. After adjustment for age, pre-existing cardiac disease, Simplified Acute Physiology (SAPS3) score, Sequential Organ Failure Assessment (SOFA) score, plasma creatinine and presence of right ventricular dysfunction, only MAPSE and LV-LWFS were independently associated with myocardial injury. None of the systolic function parameters were associated with OSFD or 30-day mortality. Conclusions MAPSE and LV-LWFS are independently associated with myocardial injury and outperform LVEF, s´ and LVLS. Whether these parameters are associated with clinical outcomes such as the need for organ support and short-term mortality is still unclear. Trial registration NCT01747187 and NCT04695119.

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Mitral annular plane systolic excursion for assessing left ventricular systolic dysfunction in patients with septic shock

Cited by 2 publications

References 36 publications

Septic Cardiomyopathy

Septic Cardiomyopathy

Association between left ventricular systolic function parameters and myocardial injury, organ failure and mortality in patients with septic shock

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