The prognostic value of left ventricular systolic function measured by tissue Doppler imaging in septic shock (Critical Care)

IntroductionLeft ventricular (LV) dysfunction is common in septic shock. Its association with clinical outcome is still controversial. Tissue Doppler imaging (TDI) is a useful tool to quantify LV function, however, few knowledge is available about the prognostic value of these TDI variables in septic shock. Therefore, we performed this prospective study to determine the role of TDI variables in septic shock. Methods: Patients with septic shock in a medical intensive care unit were studied by transthoracic echocardiography with TDI within 24 hours after the onset of septic shock. Baseline clinical, laboratory and echocardiographic variables were prospectively collected. Independent predictors of 90-day mortality were analyzed with Cox regression model. Results: During a 20-month period, 61 patients were enrolled in the study. The 90-day mortality rate was 39%; mean APACHE IV score was 84(68-97). Compared with survivors, non-survivors exhibited significantly higher peak systolic velocity measured at mitral annulus (Sa) [11.0(9.1-12.5) vs. 7.8(5.5-9.0) cm/s; p 9 cm/s [hazard ratio (HR) 5.559; 95% confidence interval (CI) 2.160 to 14.305, p