Introduction: Depression of left ventricular contractility appears in many diseases resulting from various etiology factors. One of the most interesting features of septic cardiomyopathy is the significant dynamic myocardial depression that is commonly observed. In this context, the objective of the present work is to characterize clinically, laboratory, echocardiography, and by invasive measures the patients with septic cardiomyopathy.
Methods: A single center database which investigates all the patients who were admitted and treated for severe sepsis or septic shock in the ICU over a period of two years (nov.2011-oct.2013), and who were discharged with one of diagnosis of septic cardiomyopathy or new left ventricular dysfunction. The clinical, laboratory, echocardiography, invasive measures, and clinical outcome were recorded.
Results: From the 105 patients that were investigated, 15 patients were found with septic cardiomypathy. Septic cardiomyopathy is more prevalent among men 60%. Patients with septic cardiomyopathy have an increased prevalence of immune compromised disease 46%, and hypertension 40%. There was a need for mechanical respiratory support for 86% of patients. The improvement in cardiac function occurred at an average of 6.9 days. E. Coli is the commonest bacterial pathogen 33%. Laboratory findings shows elevated liver enzyme and kidney function impairment in all the patients. 33% of patients were treated with N-Acetyl Cysteine (NAC), and 46% were treated with renal replacement therapy. High CRP was observed in all the patients. Paroxysmal atrial fibrillation was diagnosed in 46%. Invasive measures 50% of the patients have demonstrated high cardiac index (CI) and low systemic vascular resistant index (SVRI) on their admission, and 93% demonstrate low CI and high SVRI few hours later.
Hospitalization stay was between 3-42 days with an average of 14.6 days.
Conclusion: Septic cardiomypathy is more common among immune compromised patients. It is characterized by dynamic changes in the cardiac function based on echocardiography and invasive measures. A persistent hyperkinetic state associated with high mortality rate. In addition to echocardiography follow up an invasive monitoring even in their admission is of great importance for more effective and adequate treatment.
