Cardiac functions in patients with sepsis and septic shock

Introduction and aim: Sepsis is defined as the systemic inflammatory response syndrome (SIRS) which occurs during infection. One of the important features of sepsis is myocardial dysfunction. We designed this study to investigate the cardiac systolic and diastolic functions in patients presenting with SIRS and septic shock. Subjects and methods: Between July 2009 and August 2010, 40 patients diagnosed with systemic sepsis who were admitted to the Cardiac Care Unit of Mansoura Medicine Specialized Hospital were enrolled in this study. Patients were divided into 2 groups: SIRS group composed of 18 patients (13 males); and Septic shock group composed of 22 patients (11 males). Results: Indices of systolic function were significantly impaired in septic shock patients, where significantly higher left ventricular systolic (LVESD) and diastolic (LVEDD) dimensions and lower ejection fraction (EF) existed in these patients compared with SIRS group. Similar to the systolic function, the indices of diastolic function were also deranged in septic shock patients; who had significantly shorter mean isovolumetric relaxation time and deceleration time than SIRS patients; indicating the high prevalence of type 2 (pseudonormal) diastolic dysfunction in patients with septic shock compared to the milder type 1 diastolic dysfunction (impaired relaxation pattern) which predominated in SIRS patients. Conclusion: LVESD and LVEDD are significantly increased in septic shock patients compared to patients with SIRS; while EF shows the reverse. Patients with SIRS showed mild diastolic dysfunction while severe form of diastolic dysfunction has been found in patients with septic shock. (C) 2012 Egyptian Society of Cardiology. Production and hosting by Elsevier B.V. All rights reserved.