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P7.2 Identification of Vascular and Circulating Biomarkers to Predict Outcome in Patients Affected by Septic Shock

Abstract

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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This is an open access article distributed under the CC BY-NC license http://creativecommons.org/licenses/by/4.0/.

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Vallerio, P., Belli, O., Musca, F. et al. P7.2 Identification of Vascular and Circulating Biomarkers to Predict Outcome in Patients Affected by Septic Shock. Artery Res 8, 148–149 (2014). https://doi.org/10.1016/j.artres.2014.09.164

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  • DOI: https://doi.org/10.1016/j.artres.2014.09.164