tetano
Editor, Senior Moderator
Eur Respir J. 2010 Jun 1. [Epub ahead of print]
Right and left heart failure in severe H1N1 influenza A infection.
Brown SM, Pittman J, Miller RR 3rd, Horton KD, Markewitz B, Hirshberg E, Jones J, Grissom CK.
Intermountain Medical Center Murray, Utah.
Abstract
Influenza infection can affect cardiac function. The recent pandemic of H1N1 influenza A provided an opportunity to study echocardiographic findings in critically ill infected patients. We hypothesized that critically ill patients with H1N1 infection would have a higher incidence of right and left heart failure than is seen in unselected populations of patients with septic shock and/or Acute Respiratory Distress Syndrome (ARDS). We retrospectively studied all patients admitted to four ICUs at three hospitals in Salt Lake County, Utah, USA with laboratory-confirmed H1N1 infection in whom a clinical echocardiogram was available. Twenty-three of 48 patients had qualifying echocardiograms. Right ventricular (RV) dilatation (50-80%) and at least moderate systolic impairment (23%) were common, higher than the range described in general populations with ARDS. Left ventricular systolic dysfunction was present in 17% of patients. No single echocardiographic parameter was associated with 28-day mortality or ventilator-free days to 28 days. Critically ill patients with H1N1 infection frequently exhibit right heart dilatation and failure. RV basal dilatation was extremely common. These patients have less left heart failure than expected on the basis of prior descriptions of influenza myopericarditis or of general populations of septic patients.
PMID: 20516055 [PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/20516055
Right and left heart failure in severe H1N1 influenza A infection.
Brown SM, Pittman J, Miller RR 3rd, Horton KD, Markewitz B, Hirshberg E, Jones J, Grissom CK.
Intermountain Medical Center Murray, Utah.
Abstract
Influenza infection can affect cardiac function. The recent pandemic of H1N1 influenza A provided an opportunity to study echocardiographic findings in critically ill infected patients. We hypothesized that critically ill patients with H1N1 infection would have a higher incidence of right and left heart failure than is seen in unselected populations of patients with septic shock and/or Acute Respiratory Distress Syndrome (ARDS). We retrospectively studied all patients admitted to four ICUs at three hospitals in Salt Lake County, Utah, USA with laboratory-confirmed H1N1 infection in whom a clinical echocardiogram was available. Twenty-three of 48 patients had qualifying echocardiograms. Right ventricular (RV) dilatation (50-80%) and at least moderate systolic impairment (23%) were common, higher than the range described in general populations with ARDS. Left ventricular systolic dysfunction was present in 17% of patients. No single echocardiographic parameter was associated with 28-day mortality or ventilator-free days to 28 days. Critically ill patients with H1N1 infection frequently exhibit right heart dilatation and failure. RV basal dilatation was extremely common. These patients have less left heart failure than expected on the basis of prior descriptions of influenza myopericarditis or of general populations of septic patients.
PMID: 20516055 [PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/20516055