Assessment of myocardial dysfunction in septic rats with conventional echocardiography and tissue Doppler imaging

AIM To compare various conventional and tissue Doppler echocardiographic indexes to assess their accuracy to detect left ventricular (LV) intrinsic systolic and diastolic dysfunction in septic rats. METHODS Twenty-two SD rats were randomly divided into 2 groups: sham group and sepsis group, with 11 rats in each group. A model of sepsis was established by cecal ligation and puncture (CLP). Serum tumor necrosis factor-α (TNF-α) level, and myocardial intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) expression were determined by ELISA and Western blot. The LV systolic and diastolic functions were analyzed by isolated heart Langendorff perfusion technique, conventional echocardiography and tissue Doppler imaging. RESULTS Compared with sham group, the serum TNF-α level, and LV ICAM-1 and VCAM-1 expression were increased significantly, while LV ±dp/dt_max, stroke volume and LV end-diastolic volume were markedly decreased at 6 h after CLP. Moreover, compared with sham group, mitral inflow peak E and A wave velocities as well as early-diastolic peak velocities (E' wave) and late-diastolic peak velocities (A' wave) of the mitral annulus were reduced significantly in sepsis group at 6 h after CLP. In contrast, no significant difference in LV ejection fraction and E/E' ratio between sham group and sepsis group was observed. Further investigation revealed that peak E' wave and A' wave velocities were positively correlated with -dp/dt_max (r=0.460 and r=0.520, P<0.05). CONCLUSION At the early stage of sepsis, tissue Doppler echocardiography is a useful technique to assess LV diastolic dysfunction, and peak E' and A' wave velocities may be the sensitive indexes to detect LV intrinsic diastolic dysfunction.