PMID- 28398922
OWN - NLM
STAT- MEDLINE
DCOM- 20180306
LR  - 20180716
IS  - 1536-4828 (Electronic)
IS  - 0885-3177 (Linking)
VI  - 46
IP  - 5
DP  - 2017 May/Jun
TI  - Characterization of Cardiac Dysfunction by Echocardiography in Early Severe Acute
      Pancreatitis.
PG  - 626-630
LID - 10.1097/MPA.0000000000000820 [doi]
AB  - OBJECTIVE: Persistent organ failure is a feature of severe acute pancreatitis
      (SAP) and the leading cause of death. Although usually defined by hypotension,
      cardiovascular dysfunction (CD) in early SAP has not been well characterized. We 
      aim to characterize CD in patients with SAP and hypotension and determine its
      impact on clinical outcome. METHODS: Patients with SAP and hypotension were
      studied to define the frequency, nature, and prognostic significance of CD
      characterized by echocardiography and classified as systolic, diastolic, or
      combined dysfunction. RESULTS: Of the 72 patients (median age, 41 years, 44 men),
      10 (14%) had percutaneous drain placement, 12 (17%) underwent surgery, and 14
      (19%) died. Persistent hypotension was present in 58 (81%) and transient
      hypotension in 14 (19%) patients. Cardiovascular dysfunction was present in 47
      (65%) patients: 28 (60%) with diastolic dysfunction, 8 (17%) with systolic
      dysfunction, and 11 (23%) with combined dysfunction. Left ventricular end
      diastolic volume, stroke volume index, cardiac index, and diastolic dysfunction
      correlated with mortality on univariate analysis. CONCLUSIONS: Two thirds of
      patients with early SAP and hypotension had cardiac dysfunction, which was most
      commonly diastolic dysfunction. A better understanding of the nature of cardiac
      dysfunction in this setting may allow more accurate diagnosis, prognostication,
      and management.
FAU - Thandassery, Ragesh Babu
AU  - Thandassery RB
AD  - From the Departments of *Gastroenterology and daggerCardiology, Postgraduate
      Institute of Medical Education and Research, Chandigarh, India.
FAU - Choudhary, Nikhil
AU  - Choudhary N
FAU - Bahl, Ajay
AU  - Bahl A
FAU - Kochhar, Rakesh
AU  - Kochhar R
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Pancreas
JT  - Pancreas
JID - 8608542
SB  - IM
MH  - Acute Disease
MH  - Adult
MH  - Echocardiography/*methods
MH  - Female
MH  - Humans
MH  - Hypotension/complications
MH  - Male
MH  - Middle Aged
MH  - Pancreatitis/*complications/pathology
MH  - Prognosis
MH  - Severity of Illness Index
MH  - Ventricular Dysfunction/complications/diagnosis/*physiopathology
EDAT- 2017/04/12 06:00
MHDA- 2018/03/07 06:00
CRDT- 2017/04/12 06:00
PHST- 2017/04/12 06:00 [pubmed]
PHST- 2018/03/07 06:00 [medline]
PHST- 2017/04/12 06:00 [entrez]
AID - 10.1097/MPA.0000000000000820 [doi]
PST - ppublish
SO  - Pancreas. 2017 May/Jun;46(5):626-630. doi: 10.1097/MPA.0000000000000820.