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<p>Doppler parameters used to predict the maintenance of sinus rhythm after cardioversion of supraventricular arrhythmia (SVA) may be influenced by heart rate. We included patients with septic shock who developed SVA, had normal to moderately reduced left ventricular systolic function (ejection fraction &gt; 35%), and received continuous noradrenaline at doses &lt; 1.0 µg/kg/min. Cardioversion was successful in 96% of the 209 patients with the echocardiographic data available for 187 patients post cardioversion. The mitral E wave velocity decreased from 87 (76;100) cm/s during SVA to 82 (70;98) cm/s at 4 h (p = 0.001), while the newly restored mitral A wave increased from 65 (52;79) cm/s at 1 h to 69 (56;83) cm/s at 4 h (p = 0.002). Similarly, the A wave velocity–time integral (Avti) increased from 7.00 (5.63;8.28) cm to 7.65 (6.10;9.40) cm, p &lt; 0.001. A weak positive relationship between the heart rate (85 (77;95) bpm) and A wave (R<sup>2</sup> = 0.04, p &lt; 0.001) was found. No significant relationship between the heart rate and the E wave (R<sup>2</sup> = 0.001, p = 0.56), and a heart rate related decrease in the E/A ratio (R<sup>2</sup> = 0.03, p = 0.002) were observed. With accelerating heart rate, the Avti (R<sup>2</sup> = 0.02, p = 0.016), Avti/LVOTvti ratio (R<sup>2</sup> = 0.03, p = 0.006) and Avti/stroke volume ratio (R<sup>2</sup> = 0.03, p = 0.004) all increased. In patients with septic shock, mitral Doppler parameters associated with mechanical sinus rhythm after cardioversion are not significantly affected by heart rate.</p>

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Impact of heart rate on Doppler echocardiography predictors of rhythm control in patients with septic shock

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月28日

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  • Tomas Tencer,
  • Michal Maly,
  • Eva Svobodova,
  • Michal Otahal,
  • Ivana Jurisinova,
  • Pavel Trachta,
  • Adela Krajcova,
  • Frantisek Duska,
  • Petr Waldauf,
  • Martin Balik

摘要

Doppler parameters used to predict the maintenance of sinus rhythm after cardioversion of supraventricular arrhythmia (SVA) may be influenced by heart rate. We included patients with septic shock who developed SVA, had normal to moderately reduced left ventricular systolic function (ejection fraction > 35%), and received continuous noradrenaline at doses < 1.0 µg/kg/min. Cardioversion was successful in 96% of the 209 patients with the echocardiographic data available for 187 patients post cardioversion. The mitral E wave velocity decreased from 87 (76;100) cm/s during SVA to 82 (70;98) cm/s at 4 h (p = 0.001), while the newly restored mitral A wave increased from 65 (52;79) cm/s at 1 h to 69 (56;83) cm/s at 4 h (p = 0.002). Similarly, the A wave velocity–time integral (Avti) increased from 7.00 (5.63;8.28) cm to 7.65 (6.10;9.40) cm, p < 0.001. A weak positive relationship between the heart rate (85 (77;95) bpm) and A wave (R2 = 0.04, p < 0.001) was found. No significant relationship between the heart rate and the E wave (R2 = 0.001, p = 0.56), and a heart rate related decrease in the E/A ratio (R2 = 0.03, p = 0.002) were observed. With accelerating heart rate, the Avti (R2 = 0.02, p = 0.016), Avti/LVOTvti ratio (R2 = 0.03, p = 0.006) and Avti/stroke volume ratio (R2 = 0.03, p = 0.004) all increased. In patients with septic shock, mitral Doppler parameters associated with mechanical sinus rhythm after cardioversion are not significantly affected by heart rate.