[Occurrence and outcome of left ventricular-arterial coupling in sepsis-induced cardiomyopathy].

OBJECTIVE: To explore the occurrence and development of sepsis-induced cardiomyopathy (SIC) and its correlation with left ventricular arterial coupling.

METHODS: A total of 46 SIC patients were recruited and divided into non-survival and survival groups. And hemodynamics parameters, lactate, cardiac elastance (Ees), arterial elastance (Ea) and ventricular-arterial coupling (Ea/Ees), stroke work (SW), total mechanical work (PVA) and cardiac work efficiency (SW/PVA) were recorded before and after an onset of SIC.

RESULTS: The occurrence and development of SIC had close correlations with left ventricular arterial coupling.Heart and arterial elastance affected the occurrence and outcome of SIC. The former was a underlying cause while the latter a precipitating factor; the primary treatment goal of SIC was improving ventricular-arterial coupling. And the short-term objective was reducing arterial elastance and long-term strategy improving cardiac elastance; Ea declined initially when SIC recovered. And it was consistent with ventricular-arterial coupling improvement. Ees recovery was delayed; before and after SIC, low peripheral vascular resistance within 36 h could reduce arterial elastance Ea; ventricular artery coupling affected cardiac external work, work efficiency and stroke volume and was associated with tissue perfusion.

CONCLUSION: The occurrence and outcome of SIC are simultaneously influenced by Ees and Ea and are closely correlated with Ea/Ees. Treatment goal of SIC is improving ventricular-arterial coupling.Ea should be reduced within 36 h and Ees should be boosted after 48 h.