Incidencia y evolución de la miocardiopatía séptica en una cohorte de pacientes con sepsis y shock séptico / Incidence and evolution of sepsis-induced cardiomyopathy in a cohort of patients with sepsis and septic shock

OBJETIVO: El objetivo de este estudio fue determinar la incidencia de miocardiopatía séptica (MS) en pacientes con sepsis y shock séptico, describir sus características y comprobar su evolución. DISEÑO: Estudio prospectivo sobre una cohorte. PARTICIPANTES: Se incluyeron 57 pacientes consecutivos ingresados en Unidad de Cuidados Intensivos, con criterios de sepsis y shock séptico. Variables de interés principales: Se analizaron variables clínicas y bioquímicas. Se realizó un ecocardiograma en las primeras 24h de ingreso, determinando parámetros de función cardiaca, y si los pacientes presentaban una fracción de eyección de ventrículo izquierdo (FEVI)<50%, se realizó un ecocardiograma evolutivo. Ámbito: Servicio de Medicina Intensiva médico-quirúrgico de adultos en Hospital Universitario. RESULTADOS: La edad media de los pacientes fue de 62,1±16,3 años, el 58% fueron varones. El 22,8% presentaron disfunción de ventrículo izquierdo. La FEVI media en los pacientes con MS fue inferior respecto a los que no la tenían (34,1±10,6 vs. 60,7±6,94%; p < 0,001), con recuperación completa de la misma, en los supervivientes, tras el evento agudo (FEVI al alta 56,1±6,3%; p = 0,04). Los pacientes con MS, presentaban mayores niveles de procalcitonina (47,1±35,4 vs. 18,9±24,5; p = 0,02) y puntuación en la escala Sequential Organ Failure Assessment (SOFA) (9,91±3,82 vs. 7,47±3,41; p = 0,037). La mortalidad no fue significativamente diferente entre ambos grupos (4 [30,8%] vs. 4 [9,1%]; p = 0,07). CONCLUSIONES: La MS no es infrecuente, se relaciona con mayor puntuación en las escalas de gravedad. En los supervivientes, la FEVI se normalizó tras la recuperación del evento agudo

OBJECTIVE: The aim of this study was to establish the incidence of septic cardiomyopathy (SM) in patients with sepsis and septic shock, to describe its characteristics and testing its evolution. DESIGN: Prospective cohort study. PARTICIPANTS: We included 57 consecutive patients admitted to Intensive Care Unit, who met criteria of sepsis and septic shock. Principal variables of interest: Clinical and biochemical variables were analyzed. An echocardiogram was performed in the first 24hours of admission, determining myocardial function parameters, and if the patients had left ventricular ejection fraction (LVEF)<50%) a second echocardiogram was performed. Ambit: Intensive medical and surgical Care Service for Adults in University Hospital. RESULTS: The mean age of the patients was 62,1±16,3 years. 58% were males. 22.8% had left ventricular dysfunction. The mean LVEF in patients with MS was lower than those without SM (34.1±10.6 vs 60.7±6.94%, P<.001), with complete recovery, in survivors, after the acute event (LVEF at discharge 56.1±6.3%, P=.04). Patients with SM had higher levels of procalcitonin (47.1±35.4 vs 18.9±24.5; P=.02) and higher score on the Sequential Organ Failure Assessment (SOFA score) (9.91±3.82 vs 7.47±3.41; P=.037). Mortality was not significantly different between both groups [4 (30.8%) vs 4 (9.1%); P=.07]. CONCLUSIONS: SM is not uncommon and is related to a higher scores on the severity scales. In the survivors, LVEF normalized after the recovery of the acute event

Incidence and evolution of sepsis-induced cardiomyopathy in a cohort of patients with sepsis and septic shock. / Incidencia y evolución de la miocardiopatía séptica en una cohorte de pacientes con sepsis y shock séptico.

OBJETIVE: The aim of this study was to establish the incidence of septic cardiomyopathy (SM) in patients with sepsis and septic shock, to describe its characteristics and testing its evolution. DESIGN: Prospective cohort study. PARTICIPANTS: We included 57 consecutive patients admitted to Intensive Care Unit, who met criteria of sepsis and septic shock. PRINCIPAL VARIABLES OF INTEREST: Clinical and biochemical variables were analyzed. An echocardiogram was performed in the first 24hours of admission, determining myocardial function parameters, and if the patients had left ventricular ejection fraction (LVEF)<50%) a second echocardiogram was performed. AMBIT: Intensive medical and surgical Care Service for Adults in University Hospital. RESULTS: The mean age of the patients was 62,1±16,3 years. 58% were males. 22.8% had left ventricular dysfunction. The mean LVEF in patients with MS was lower than those without SM (34.1±10.6 vs 60.7±6.94%, P<.001), with complete recovery, in survivors, after the acute event (LVEF at discharge 56.1±6.3%, P=.04). Patients with SM had higher levels of procalcitonin (47.1±35.4 vs 18.9±24.5; P=.02) and higher score on the Sequential Organ Failure Assessment (SOFA score) (9.91±3.82 vs 7.47±3.41; P=.037). Mortality was not significantly different between both groups [4 (30.8%) vs 4 (9.1%); P=.07]. CONCLUSIONS: SM is not uncommon and is related to a higher scores on the severity scales. In the survivors, LVEF normalized after the recovery of the acute event.