Prevalence and prognosis of hyperdynamic left ventricular systolic function in septic patients: a systematic review and meta-analysis,Annals of Intensive Care

当前位置： X-MOL 学术 › Ann. Intensive Care › 论文详情

Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)

Prevalence and prognosis of hyperdynamic left ventricular systolic function in septic patients: a systematic review and meta-analysis
Annals of Intensive Care ( IF 5.7 ) Pub Date : 2024-02-03 , DOI: 10.1186/s13613-024-01255-9
Ryota Sato ₁ , Filippo Sanfilippo ₂ , Daisuke Hasegawa ₃ , Narut Prasitlumkum ₄ , Abhijit Duggal _{5,

6} , Siddharth Dugar _{5,

6}

Affiliation

Purpose

The prevalence of hyperdynamic left ventricular (LV) systolic function in septic patients and its impact on mortality remain controversial. In this systematic review and meta-analysis, we investigated the prevalence and association of hyperdynamic LV systolic function with mortality in patients with sepsis.

Methods

We searched MEDLINE, Cochrane Central Register of Controlled Trials, and Embase. Primary outcomes were the prevalence of hyperdynamic LV systolic function in adult septic patients and the associated short-term mortality as compared to normal LV systolic function. Hyperdynamic LV systolic function was defined using LV ejection fraction (LVEF) of 70% as cutoff. Secondary outcomes were heart rate, LV end-diastolic diameter (LVEDD), and E/e’ ratio.

Results

Four studies were included, and the pooled prevalence of hyperdynamic LV systolic function was 18.2% ([95% confidence interval (CI) 12.5, 25.8]; I² = 7.0%, P < 0.0001). Hyperdynamic LV systolic function was associated with higher mortality: odds ratio of 2.37 [95%CI 1.47, 3.80]; I² = 79%, P < 0.01. No difference was found in E/e’ (P = 0.43) between normal and hyperdynamic LV systolic function, while higher values of heart rate (mean difference: 6.14 beats/min [95%CI 3.59, 8.69]; I² = 51%, P < 0.0001) and LVEDD (mean difference: − 0.21 cm [95%CI − 0.33, − 0.09]; I² = 73%, P < 0.001) were detected in patients with hyperdynamic LV systolic function.

Conclusion

The prevalence of hyperdynamic LV systolic function is not negligible in septic patients. Such a finding is associated with significantly higher short-term mortality as compared to normal LV systolic function.

中文翻译：

脓毒症患者左心室收缩功能亢进的患病率和预后：系统评价和荟萃分析

目的

脓毒症患者左心室（LV）收缩功能亢进的患病率及其对死亡率的影响仍存在争议。在这项系统评价和荟萃分析中，我们调查了脓毒症患者高动力左室收缩功能与死亡率的患病率及其关联。

方法

我们检索了 MEDLINE、Cochrane 对照试验中心注册库和 Embase。主要结局是成年脓毒症患者左室收缩功能高动力的患病率以及与正常左室收缩功能相比相关的短期死亡率。使用 70% 的 LV 射血分数 (LVEF) 作为临界值来定义高动力 LV 收缩功能。次要结果是心率、左心室舒张末期内径 (LVEDD) 和 E/e' 比。

结果

纳入四项研究，左室收缩功能高动力的汇总患病率为 18.2%（[95% 置信区间 (CI) 12.5, 25.8]； I ² = 7.0%， P < 0.0001）。高动力左室收缩功能与较高的死亡率相关：优势比为 2.37 [95%CI 1.47, 3.80]； I ² = 79%， P < 0.01。正常和高动力左室收缩功能之间的 E/e' ( P = 0.43) 没有差异，而心率值较高（平均差异：6.14 次/分钟 [95%CI 3.59, 8.69]； I ² = 51% ， P < 0.0001）和 LVEDD（平均差：− 0.21 cm [95% CI − 0.33，− 0.09]； I ² = 73%， P < 0.001）在左心室收缩功能亢进的患者中检测到。