P7.2 IDENTIFICATION OF VASCULAR AND CIRCULATING BIOMARKERS TO PREDICT OUTCOME IN PATIENTS AFFECTED BY SEPTIC SHOCK

P. Vallerio; O. Belli; F. Musca; G. Monti; L. Bonacchini; M. Cazzaniga; M. Stucchi; P. Meani; L. Frigerio; M. Molteni; F. Panzeri; M. Alloni; R. Fumagalli; A. De Gasperi; C. Giannattasio

doi:10.1016/j.artres.2014.09.164

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Volume 8, Issue 4, December 2014, Pages 148 - 149

P7.2 IDENTIFICATION OF VASCULAR AND CIRCULATING BIOMARKERS TO PREDICT OUTCOME IN PATIENTS AFFECTED BY SEPTIC SHOCK

Authors

P. Vallerio^b, O. Belli^b, F. Musca^b, G. Monti^c, L. Bonacchini^a, M. Cazzaniga^a, M. Stucchi^a, P. Meani^a, L. Frigerio^a, M. Molteni^a, F. Panzeri^a, M. Alloni^b, R. Fumagalli^a^{, c}, A. De Gasperi^d, C. Giannattasio^a^{, b}

^aMilano-Bicocca University, Milano, Italy

^bCardiologia IV, Ospedale Niguarda Ca’ Granda, Milano, Italy

^cIntensive Care Unit 2, Ospedale Niguarda Ca’ Granda, Milano, Italy

^dIntensive Care Unit 3, Ospedale Niguarda Ca’ Granda, MIlano, Italy

Available Online 4 November 2014.

DOI: 10.1016/j.artres.2014.09.164 How to use a DOI?
Open Access: This is an open access article distributed under the CC BY-NC license.

Introduction: Cardiovascular dysfunction is a well-recognized early complication of septic shock (SS). A hallmark of SS is a change in microvascular function and endothelial cell (EC) activation, contributing to multiple organ failure. Angiopoietin (Ang1-2) pathway has been reported associated with severity of illness and mortality.

Aim: to evaluate prognostic and clinical role of functional vascular assessment in patients with SS.

Methods: We enrolled 20 patients from intensive care units with a diagnosis of SS. Clinical, hemodynamic, instrumental evaluations and blood sample collection were obtained at hospitalization (T1), and one week later (T2). We assessed echocardiographic left ventricular systolic function (LVEF) and functional arteries evaluation with carotid-femoral PWV (Complior).

Results: During the follow-up 11 patients survived (S) and 9 died (D). S and D had similar ages (62±8vs66±11 yrs, means±SD), MAP (80±12vs81±12 mmHg, means±SD) and SOFA score (13±4vs15±4, means±SD). At T1, D had a significantly higher cf-PWV than S (12±3vs9±2 m/s, means±SD; p0.05). Furthermore considering all patients toghether, we found an inverse correlation between PWV and LVEF (p<0.01). Finally, S had a significant T1-T2 increase in Ang1 (7339[4587-17010]vs47384[10658-53645] medians[25-75th]; p<0.05) and a decrease in Ang2 levels (27783±17625vs9008±5565 means+SD; p<0.01); D patients showed an inverse trend.

Conclusions: In SS endothelial dysfunction caused by EC-activation is expressed by an increase of PWV, which was significantly different depending on outcome of patients. PWV also has a correlation with LVEF. The values of PWV could express an alteration of ventricular-vascular coupling, useful to monitor response to therapy as well as pharmacologic support of the circulation.

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Journal: Artery Research
Volume-Issue: 8 - 4
Pages: 148 - 149
Publication Date: 2014/11/04
ISSN (Online): 1876-4401
ISSN (Print): 1872-9312
DOI: 10.1016/j.artres.2014.09.164 How to use a DOI?
Open Access: This is an open access article distributed under the CC BY-NC license.

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ris enw bib

TY  - JOUR
AU  - P. Vallerio
AU  - O. Belli
AU  - F. Musca
AU  - G. Monti
AU  - L. Bonacchini
AU  - M. Cazzaniga
AU  - M. Stucchi
AU  - P. Meani
AU  - L. Frigerio
AU  - M. Molteni
AU  - F. Panzeri
AU  - M. Alloni
AU  - R. Fumagalli
AU  - A. De Gasperi
AU  - C. Giannattasio
PY  - 2014
DA  - 2014/11/04
TI  - P7.2 IDENTIFICATION OF VASCULAR AND CIRCULATING BIOMARKERS TO PREDICT OUTCOME IN PATIENTS AFFECTED BY SEPTIC SHOCK
JO  - Artery Research
SP  - 148
EP  - 149
VL  - 8
IS  - 4
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2014.09.164
DO  - 10.1016/j.artres.2014.09.164
ID  - Vallerio2014
ER  -

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