Right Ventricular Dysfunction and Dilatation, Similar to Left Ventricular Changes

8 Mar


Septic shock in humans is usually characterized by a hyperdynamic hemodynamic profile. During human septic shock, reversible depression of left ventricular ejection fraction and dilatation of the left ventricle have been described using radionuclide angiography or echocardiography. These changes in left ventricular function and size are transient and return toward normal in survivors at seven to ten days after the onset of septic shock.

Right ventricular function in septic shock has not been as well studied as left ventricular function. Kimchi et al reported a decreased right ventricular ejection fraction in 13 of 25 patients with septic shock. In that study, right ventricular ejection fraction did not correlate with pulmonary artery pressure or pul­monary vascular resistance index, leading the authors to conclude that the right ventricular depression was not due to a sepsis-induced pulmonary vascular ab­normality. However, these investigators did not sys­tematically study the relationship of left-to-right ven­tricular function, nor did they report or evaluate serial changes in ventricular function. levitra plus

To gain further insight regarding the serial relation­ship of right and left ventricular size and function and to evaluate any relationships between ventricular performance and survival in humans with septic shock, we performed serial catheter-derived hemo­dynamic studies and simultaneous radionuclide ven­triculography. These studies evaluated, in a more comprehensive fashion, the response of the right ventricle to septic shock and the possible relationship of right and left ventricular dysfunction to other sepsis- induced abnormalities.