■脓毒症是一种危及生命的器官功能障碍,和脓毒性心肌病(SCM)可能会使疾病的进程复杂化。多药耐药(MDR)病原体感染与更差的结果有关。本研究旨在评估SCM在由不同抗菌素耐药表型引起的感染患者中的应用。
■这项回顾性研究包括脓毒症/脓毒性休克患者,住院,并在2022年1月至2023年9月期间在拉里萨大学医院的重症监护病房进行了插管,并在感染发作后的头两天内获得了超声心动图数据。将患者分为两组:非MDR-SCM组和MDR-SCM组。比较两组患者的心功能。
■共62名患者纳入研究。44例患者包括MDR-SCM和18例非MDR-SCM组。26例患者(41.9%)出现左心室(LV)收缩功能障碍,≤35%的右心室面积变化(RVFAC)占56.4%。非MDR-SCM组的左心室收缩功能受损更严重(左心室射血分数,35.8%±4.9%vs.45.6%±2.4%,P=0.049;低压流出道速度时间积分,[10.1±1.4]cmvs.[15.3±0.74]cm,P=0.001;LV应变,-9.02%±0.9%与-14.02%±0.7%,P=0.001)。MDR-SCM组表现为更严重的右心室(RV)扩张(右心室舒张末期面积/左心室舒张末期面积,0.81±0.03vs.0.7±0.05,P=0.042)和较差的RV收缩功能(RVFAC,32.3%±1.9%vs.39.6%±2.7%,P=0.035;三尖瓣环平面收缩期偏移,[15.9±0.9]mmvs.[18.1±0.9]mm,P=0.165;在三尖瓣外侧环测量的收缩组织多普勒速度,[9.9±0.5]cm/svs.[13.1±0.8]cm/s,P=0.002;RV应变,-11.1%±0.7%与-15.1%±0.9%,P=0.002)。
■与MDR感染相关的SCM表现为RV收缩功能障碍占优势,而非MDR-SCM主要表现为左心室收缩功能障碍。
UNASSIGNED: Sepsis is a life-threatening organ dysfunction, and septic cardiomyopathy (SCM) may complicate the course of the disease. Infection with multidrug-resistant (MDR) pathogens has been linked with worse outcomes. This study aims to evaluate SCM in patients with infections caused by different antimicrobial-resistant phenotypes.
UNASSIGNED: This retrospective study included patients with sepsis/septic shock, hospitalized, and intubated in the intensive care unit of the University Hospital of Larissa between January 2022 and September 2023 with echocardiographic data during the first two days after infection onset. The patients were divided into two groups: non-MDR-SCM group and MDR-SCM group. The cardiac function was compared between the two groups.
UNASSIGNED: A total of 62 patients were included in the study. Forty-four patients comprised the MDR-SCM and 18 the non-MDR-SCM group. Twenty-six patients (41.9%) presented with left ventricular (LV) systolic dysfunction, and ≤35% right ventricular fractional area change (RVFAC) was present in 56.4%. LV systolic function was more severely impaired in the non-MDR-SCM group (left ventricular ejection fraction, 35.8% ±4.9% vs. 45.6%±2.4%, P=0.049; LV outflow tract velocity time integral, [10.1±1.4] cm vs. [15.3±0.74] cm, P=0.001; LV-Strain, -9.02%±0.9% vs. -14.02%±0.7%, P=0.001). The MDR-SCM group presented with more severe right ventricular (RV) dilatation (right ventricular end-diastolic area/left ventricular end-diastolic area, 0.81±0.03 vs. 0.7±0.05, P=0.042) and worse RV systolic function (RVFAC, 32.3%±1.9% vs. 39.6%±2.7%, P=0.035; tricuspid annular plane systolic excursion, [15.9±0.9] mm vs. [18.1±0.9] mm, P=0.165; systolic tissue Doppler velocity measured at the lateral tricuspid annulus, [9.9±0.5] cm/s vs. [13.1±0.8] cm/s, P=0.002; RV-strain, -11.1%±0.7% vs. -15.1%±0.9%, P=0.002).
UNASSIGNED: SCM related to MDR infection presents with RV systolic dysfunction predominance, while non-MDR-SCM is mainly depicted with LV systolic dysfunction impairment.