Left ventricular torsion abnormalities in septic shock and corrective effect of volume loading: a pilot study

Bloechlinger, Stefan; Berger, David; Bryner, Jürg; Wiegand, Jan; Dünser, Martin W.; Takala, Jukka (2013). Left ventricular torsion abnormalities in septic shock and corrective effect of volume loading: a pilot study. Canadian journal of cardiology, 29(12), pp. 1665-1671. Canadian Cardiology Publications 10.1016/j.cjca.2013.10.007

[img] Text
ccd25224.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (462kB) | Request a copy

BACKGROUND Ventricular torsion is an important component of cardiac function. The effect of septic shock on left ventricular torsion is not known. Because torsion is influenced by changes in preload, we compared the effect of fluid loading on left ventricular torsion in septic shock with the response in matched healthy control subjects. METHODS We assessed left ventricular torsion parameters using transthoracic echocardiography in 11 patients during early septic shock and in 11 age- and sex-matched healthy volunteers before and after rapid volume loading with 250 mL of a Ringer's lactate solution. RESULTS Peak torsion and peak apical rotation were reduced in septic shock (10.2 ± 5.2° and 5.6 ± 5.4°) compared with healthy volunteers (16.3 ± 4.5° and 9.6 ± 1.5°; P = 0.009 and P = 0.006 respectively). Basal rotation was delayed and diastolic untwisting velocity reached its maximum later during diastole in septic shock patients than in healthy volunteers (104 ± 16% vs 111 ± 14% and 13 ± 5% vs 21 ± 10%; P = 0.03 and P = 0.034, respectively). Fluid challenge increased peak torsion in both groups (septic shock, 10.2 ± 5.3° vs 12.6 ± 3.9°; healthy volunteers, 16.3 ± 4.5° vs 18.1 ± 6°; P = 0.01). Fluid challenge increased left ventricular stroke volume in septic shock patients (P = 0.003). CONCLUSIONS Compared with healthy volunteers, left ventricular torsion is impaired in septic shock patients. Fluid loading attenuates torsion abnormalities in parallel with increasing stroke volume. Reduced torsional motion might constitute a relevant component of septic cardiomyopathy, a notion that merits further testing in larger populations.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic of Intensive Care
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Blöchlinger, Stefan; Berger, David; Wiegand, Jan and Takala, Jukka

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0828-282X

Publisher:

Canadian Cardiology Publications

Language:

English

Submitter:

Daria Vogelsang

Date Deposited:

24 Mar 2014 10:22

Last Modified:

29 Oct 2015 10:46

Publisher DOI:

10.1016/j.cjca.2013.10.007

PubMed ID:

24267806

BORIS DOI:

10.7892/boris.46346

URI:

https://boris.unibe.ch/id/eprint/46346

Actions (login required)

Edit item Edit item
Provide Feedback