败血症性心肌病具有广泛的表现,与收缩和/或舒张功能障碍有关。目前尚无证据表明败血症患者的左心室(LV)收缩功能障碍与死亡率之间存在关联。
我们进行了系统评价和荟萃分析,以研究组织多普勒成像(TDI)获得的收缩期波(s\')与脓毒症患者死亡率之间的关系。次要结果是LV射血分数与死亡率的关联。
在主要分析中,我们共纳入了13项研究(1197例患者,死亡率39.9%);幸存者和非幸存者之间的总体s波没有显着差异(标准化平均差0.20,95%置信区间-0.18,0.59)。根据TDI抽样的区域标准,在亚组分析中也证实了这一结果。仅包括脓毒性休克患者的事后分析证实,s波与死亡率无关。一些敏感性分析证实了这些结果。我们没有发现发表偏倚的证据。次要分析(11项研究,1081名患者,死亡率36.7%)显示左心室射血分数与死亡率无关(平均差0.98,95%置信区间-1.79,3.75)。
在脓毒症患者中,通过TDIs波评估,死亡率和左心室收缩功能之间没有关联。
Septic induced cardiomyopathy has a wide spectrum of presentation, being associated with systolic and/or diastolic dysfunction. There is currently no evidence of association between left ventricular (LV) systolic dysfunction and mortality in septic patients.
We conducted a systematic
review and meta-analysis to investigate the association between systolic wave (s\') obtained with Tissue Doppler Imaging (TDI) and mortality in septic patients. Secondary outcome was the association of LV ejection fraction with mortality.
In the primary analysis we included a total of 13 studies (1197 patients, mortality 39.9%); overall s\' wave was not significantly different between survivors and non-survivors (Standardized Mean Difference 0.20, 95%Confidence-Interval - 0.18, 0.59). This result was confirmed also in sub-groups analyses according to regional criteria of TDI sampling. A post-hoc analysis including only septic shock patients confirmed that s\' wave was not associated with mortality. Several sensitivity analyses confirmed these results. We found no evidence of publication bias. The secondary analysis (11 studies, 1081 patients, mortality 36.7%) showed that LV ejection fraction was not associated with mortality (Mean Difference 0.98, 95% Confidence-Interval - 1.79,3.75).
There is no association between mortality and LV systolic function as evaluated by TDI s\' wave in septic patients.