Tachycardia was associated with abnormal left ventricular longitudinal strain in septic patients, an association that persisted primarily in those with high cardiac preload (β = 0.07, p = 0.016).
Observational (n=452)
Yes
Is tachycardia associated with abnormal left ventricular longitudinal strain in septic patients across different preload states?
Tachycardia is associated with abnormal left ventricular strain specifically in septic patients with high preload, suggesting it may reflect a maladaptive hyperadrenergic state (septic cardiomyopathy) rather than a compensatory response to hypovolemia.
Effect estimate: β = 0.05
p-value: p=0.003
BACKGROUND: In sepsis, tachycardia may indicate low preload, adrenergic stimulation, or both. Adrenergic overstimulation is associated with septic cardiomyopathy. We sought to determine whether tachycardia was associated with left ventricular longitudinal strain, a measure of cardiac dysfunction. We hypothesized an association would primarily exist in patients with high preload. METHODS: We prospectively observed septic patients admitted to three study ICUs, who underwent early transthoracic echocardiography. We measured longitudinal strain using speckle tracking echocardiography and estimated preload status with an echocardiographic surrogate (E/e'). We assessed correlation between strain and heart rate in patients with low preload (E/e' 14), adjusting for disease severity and vasopressor dependence. RESULTS: We studied 452 patients, of whom 298 had both measurable strain and preload. Abnormal strain (defined as >-17%) was present in 54%. Patients with abnormal strain had higher heart rates (100 vs. 93 beat/min, p = 0.001). After adjusting for vasopressor dependence, disease severity, and cardiac preload, we observed an association between heart rate and longitudinal strain (β = 0.05, p = 0.003). This association persisted among patients with high preload (β = 0.07, p = 0.016) and in patients with shock (β = 0.07, p = 0.01), but was absent in patients with low or intermediate preload and those not in shock. CONCLUSIONS: Tachycardia is associated with abnormal left ventricular strain in septic patients with high preload. This association was not apparent in patients with low or intermediate preload.
Lanspa et al. (Sun,) conducted a observational in Sepsis (n=452). Tachycardia (Heart rate) was evaluated on Left ventricular longitudinal strain (β = 0.05, p=0.003). Tachycardia was associated with abnormal left ventricular longitudinal strain in septic patients, an association that persisted primarily in those with high cardiac preload (β = 0.07, p = 0.016).