scholarly journals The Correlation Between Whole Blood Copper (Cu), Zinc (Zn) Levels and Cu/Zn Ratio and Sepsis-Induced Left Ventricular Systolic Dysfunction (SILVSD) in Patients with Septic Shock: A Single-Center Prospective Observational Study

2021 ◽  
Vol Volume 14 ◽  
pp. 7219-7234
Author(s):  
Jian-Biao Meng ◽  
Ma-Hong Hu ◽  
Ming Zhang ◽  
Gong-Pai Hu ◽  
Wei Zhang ◽  
...  
2020 ◽  
Author(s):  
Jian-Biao Meng ◽  
Ma-Hong Hu ◽  
Wei Zhang ◽  
Gong-Pai Hu ◽  
Xiao-Gang Guo ◽  
...  

Abstract Background: The dyshomeostasis of trace elements is associated with multiple organ dysfunction in patients with septic shock. However, it remains unclear whether the change of whole blood copper (Cu) and zinc (Zn) levels influence cardiac function in patients with septic shock. Here, we sought to explore relationship between whole blood Cu and Zn and cardiac dysfunction in septic shock. Methods: Between April 2018 and March 2020, septic shock patients with sepsis-induced left ventricular systolic dysfunction (SILVSD, left ventricular ejection fraction, LVEF < 50%) and with no sepsis-induced myocardial dysfunction (non-SIMD, septic shock alone and LVEF> 50%) on an intensive care unit (ICU) in south China and healthy controls were prospectively enrolled. whole blood Cu and Zn levels were measured using flame atomic absorption spectrophotometry.Results: 86 patients with septic shock including 41 SILVSD and 45 non-SIMD and 25 healthy controls were studied. Whole blood Cu levels were significantly higher and Zn were significantly lower in SILVSD compared with non-SIMD and controls [Cu, (16.34±1.93) vs. (15.23±2.07) vs. (14.02±1.65) µmol/L, p = 0.009, < 0.001; Zn, (78.45±12.18) vs. (85.07±14.80) vs. (94.90±14.78) µmol/L, p = 0.029, < 0.001]. Both increased whole blood Cu and reduced Zn were associated with lower LVEF ( all p < 0.001) and higher amino-terminal pro-B-type natriuretic peptide (NT-proBNP) (Cu, p = 0.002, Zn, p = 0.001), and had predictive values for SILVSD [Cu, (AUC = 0.666; p = 0.005) ; Zn, (AUC = 0.625; p = 0.039)]. Whole blood Cu levels were increased but Zn were reduced in non-survivors compared with survivors[Cu, (17.20 ±2.25) vs. (14.99 ±1.49) µmol/L, p < 0.001; Zn, (71.17 ±11.98) vs. (87.67±11.30) µmol/L, p < 0.001],. Whole blood Cu and Zn displayed the value of predicting 28-day mortality [Cu (AUC = 0.802, p < 0.001); Zn (AUC = 0.869, p < 0.001)].Conclusions: Whole blood Cu levels were increased in SILVSD patients and positively correlated with the cardiac dysfunction while Whole blood Zn were reduced and negatively associated with the cardiac dysfunction. Moreover, both whole blood Cu and Zn could distinguish between SILVSD and non-SIMD in septic shock patients and predict 28-day mortality.Trial registration: ChiCTR1800015709. Registered 16 April 2018, http://www.chictr.org.cn/edit.aspx?pid=26746&htm=4.


2016 ◽  
Vol 33 (12) ◽  
pp. 680-686 ◽  
Author(s):  
Saraschandra Vallabhajosyula ◽  
Shane M. Gillespie ◽  
David W. Barbara ◽  
Nandan S. Anavekar ◽  
Juan N. Pulido

Background: Left ventricular systolic dysfunction (LVSD) and LV diastolic dysfunction (LVDD) are commonly seen in severe sepsis and septic shock; however, their role in patients with concurrent invasive mechanical ventilation (IMV) is less well defined. Methods: This was a prospective observational study on all patients admitted to all the intensive care units (ICUs) at Mayo Clinic, Rochester from August 2007 to January 2009. All adult patients with severe sepsis and septic shock and concurrent IMV without prior heart failure underwent transthoracic echocardiography within 24 hours. Patients with active pregnancy, prior congenital or valvular heart disease, and prosthetic cardiac valves were excluded. Left ventricular systolic dysfunction was defined as LV ejection fraction (LVEF) <50% and LVDD as E/e′ >15. Primary outcome was hospital mortality, and secondary outcomes included IMV duration, ICU length of stay (LOS), and total LOS. Two-tailed P value of <.05 was considered statistically significant. Results: In a total of 106 patients, 58 (54.7%) met our inclusion criteria, with 17 (29.3%), 11 (19.0%), and 5 (8.6%) having LVSD, LVDD, and both, respectively. The cohorts with and without LVSD and LVDD did not differ significantly in their baseline characteristics and laboratory and ventilatory parameters. Compared to those without LVSD, patients with LVSD had higher LV end-systolic diameters but were not different in their left atrial diameters or E/e′ ratio. Patients with LVDD had a higher E velocity and E/e′ ratio compared to those without LVDD. Hospital mortality was not different in patients with and without LVSD (8 [47%] vs 21 [51%], P = 1.00) and LVDD (8 [73%] vs 21 [45%], P = .18). Secondary outcomes were not different between the 2 groups. Conclusion: Left ventricular systolic or diastolic dysfunction did not influence in-hospital outcomes in patients with severe sepsis and septic shock and concurrent IMV.


2017 ◽  
Vol 43 (5) ◽  
pp. 633-642 ◽  
Author(s):  
Florence Boissier ◽  
Keyvan Razazi ◽  
Aurélien Seemann ◽  
Alexandre Bedet ◽  
Arnaud W. Thille ◽  
...  

2020 ◽  
Vol 2020 ◽  
pp. 1-6 ◽  
Author(s):  
Pham Dang Hai ◽  
Le Lan Phuong ◽  
Nguyen Manh Dung ◽  
Le Thi Viet Hoa ◽  
Do Van Quyen ◽  
...  

Introduction. Left ventricular dysfunction is quite common in septic shock. Speckle-tracking echocardiography (STE) is a novel, highly sensitive method for assessing left ventricular function, capable of detecting subclinical myocardial dysfunction, which is not identified with conventional echocardiography. We sought to evaluate subclinical left ventricular systolic function in patients with septic shock using speckle-tracking echocardiography. Methods. From May 2017 to December 2018, patients aged ≥18 years admitted to the intensive care unit with the diagnosis of sepsis and septic shock based on the sepsis-3 definition were included. Patients with other causes of cardiac dysfunction were excluded. Transthoracic echocardiography was performed for all the patients within 24 hours of diagnosis. Left ventricular systolic function was assessed using conventional echocardiography and speckle-tracking echocardiography. Results. Patients with septic shock (n = 90) (study group) and 37 matched patients with sepsis but no septic shock (control group) were included. Left ventricular ejection fraction (LVEF) by conventional echocardiography showed no significant difference between two groups (58.2 ± 9.9 vs. 58.6 ± 8.3, p=0.804). The global longitudinal strain (GLS) by STE was significantly reduced in patients with septic shock compared with that in the control (−14.6 ± 3.3 vs. −17.1 ± 3.3, p<0.001). Based on the cutoff value of GLS ≥ −15% for the definition of subclinical left ventricular systolic dysfunction, this dysfunction was detected in 50 patients with septic shock (55.6%) and in 6 patients in the control group (16.2%) (p<0.05). Conclusions. Speckle-tracking echocardiography can detect early subclinical left ventricular systolic dysfunction via the left ventricular global longitudinal strain compared with conventional echocardiographic parameters in patients with septic shock.


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