Role of afterload-related cardiac performance in evaluating cardiac dysfunction and prognosis in patients with septic shock
10.12007/j.issn.0258-4646.2025.08.007
- VernacularTitle:后负荷相关的心脏做功对脓毒症休克患者心功能障碍和预后的评估价值
- Author:
Tengfei WANG
1
;
Liwei HUA
1
;
Jinxin PAN
1
;
Kun ZHANG
1
;
Jiading XIA
1
Author Information
1. 承德医学院附属医院重症医学科,河北承德 067000
- Publication Type:Journal Article
- Keywords:
septic shock;
septic cardiomyopathy;
cardiac dysfunction;
afterload
- From:
Journal of China Medical University
2025;54(8):709-713,719
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the value of afterload-related cardiac performance(ACP)in evaluating cardiac dysfunction and prognosis in patients with septic shock.Methods This prospective observational study included 45 patients with septic shock.The patients were divided into the death(n=21)or survival(n=24)group according to whether they died within 28 days.Baseline and labora-tory data were collected within 24 h.Cardiac function indices were collected and monitored at 0,6,12,18,and 24 h using the pulse index continuous cardiac output.Variables affecting the prognosis were included in the multivariate Cox proportional hazard model.Prognosis was predicted using a receiver operating characteristic(ROC)curve.Results The ACP in the death group was significantly lower than that in the survival group at 0,6,12,18,and 24 h(all P＜0.05).Logistic regression analysis showed that decreased ACP,increased acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score,increased sequential organ failure assessment(SOFA)score,increased fluid balance at 24 h,increased vasoactive-inotropic score,increased central venous pressure,and decreased mean arterial pressure were risk factors for poor prognosis.The Cox proportional hazard model showed that ACP,APACHE Ⅱ score,and SOFA score were independent risk factors influencing prognosis.ROC analysis showed that the area under the curve of ACP was the largest at 24 h,which was the best time point for predicting 28-day mortality.The corresponding sensitivity,specificity,and best cutoff values were 76.20％,91.70％,and 75.16％,respectively.Conclusion ACP could be used as a valuable index to evaluate cardiac dysfunction and as an independent risk factor for poor prognosis in patients with septic shock.
