A PROSPECTIVE STUDY ABOUT THE CARDIAC PERFORMANCE IN THE CHINESE PATIENTS WITH SEPTIC SHOCK: THE SYSTOLIC FUNCTION ASSESSED BY TISSUE DOPPLER IMAGING AND THE BIOMARKERS

Objectives This study was to analyse evolution of the left ventricular (LV) systolic function assessed by Tissue Doppler imaging (TDI) and its predictive value to the prognosis in Chinese patients with septic shock, and to evaluate the correlation between these parameters and cardiac biomarkers including cardiac tropnin I (cTnI) and N-terminal-pro-BNP (NT-proBNP). Methods This study prospectively recruited 69 patients within 24 h after the onset of septic shock. The clinical variables, cardiac biomarkers and echocardiography data were obtained and analysed on admission (day 1) and at day 2, 4, 7 and 10 or 24 h after the correction of shock. The primary endpoint was 90 days all-cause mortality. Results The 90 days all-cause mortality which was 40.6% in this study. The survivors had a lower peak myocardial systolic velocity (Sm) which emerged as an independent predictor of the 90 days mortality in the multivariate analysis at day 1. There was no difference in the baseline level of biomarkers. During the mean follow-up period of 4.8 days, NT-proBNP and cTnI decreased significantly and Sm improved significantly in the survivors; the non-survivors showed a significantly increased NT-proBNP, unchanged cTnI and Sm. The biomarkers correlated significantly with Sm and LVEF both in the baseline and in the follow-up only in the survivors. The correlation of NT-proBNP with cTnI remained significant throughout the follow-up period in both groups. Conclusions LV systolic function assessed by TDI related to the prognosis of patients with septic shock. The level of biomarkers decreased and strong correlations could be found between the biomarkers and LV systolic function in the 90 days survivors after the onset of septic shock.