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      《Chinese Journal of Critical Care Medicine》 2019-05
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      Analysis of risk factors for sepsis-induced Takotsubo cardiomyopathy

      Ge Jian-hui;Ge Xiang-jun;Department of Emergency Medicine,Ninghai First Hospital;  
      Objective To analyze the risk factors for sepsis-induced Takotsubo cardiomyopathy(TTC).Methods A total of 241 cases with sepsis admitted to our hospital from March2015 to March 2018 were analyzed.Clinical parameters at admission were collected:age,sex,body mass index,echocardiography results,and laboratory parameters such as inflammation index and myocardial enzyme spectrum.According to the selected TTC patients,sepsis patients with normal cardiac function were selected and divided into TTC group and non-TTC group.Variables with significant statistical significance in the univariate analysis were introduced with multivariate logistic regression analysis of sepsis-induced risk factors for TTC.Results There were 31 cases in TTC group and 210 cases in the non-TTC group.The males in the TTC group were significantly lower than those in the nonTTC group(35.5% vs.56.7%,P=0.027),and the myocardial enzyme spectrum of cTnT,NTproBNP,and CK-MB were significantly higher in the TTC group(P0.05).In treatment regimens,the proportion of introotropic drugs used in the TTC group was significantly higher than that in the nonTTC group(45.2% vs.26.7%,P=0.034).Echocardiographic results showed a significant reduction in left ventricular ejection fraction in the TTC group(39.5 ±10.4 vs.59.3 ±5.7,P0.001).The left ventricular end systolic diameter(LVIDs)(3.42 ±0.74 vs.2.59 ±0.53,P0.001)and left ventricular end-diastolic diameter(LVIDd)(4.62 ±0.52 vs. 4.31±0.51,P=0.002)increased compared with the non-TTC group.There was no statistical difference in diastolic function parameters such as E wave(P=0.160),A wave(P=0.093),E wave deceleration time(P=0.098)and E and e'(s)ratio(P=0.649).Multivariate analysis showed that troponin T(OR=1.965,95%CI 1.122-3.785,P0.001)and inotrope(OR=1.445,95%CI 1.217-4.263,P0.001)were independent risk factors for sepsis-induced TTC.Concluson Increased troponin levels and positive inotropic agents are risk factors for TTC after sepsis.Early detection and prevention of these high-risk patients is warranted.
      【CateGory Index】: R459.7;R542.2
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