A previous study from this department demonstrated a reversible depression of radionuclide-determined ejection fraction in survivors of septic shock. In order to further characterize the myocardial response to septic shock and, in particular, the difference in left ventricular function between survivors and non- survivors of septic shock, serial radionuclide angiography with simultaneous hemodynamic measurements are performed. The studies are done on the first day of septic shock, on day 3 or 4, and a week to 10 days after the onset of shock to try to determine the patterns of response in the two groups. Survivors of septic shock show a decrease in ejection fraction accompanied by dilation of the left ventricle over the first 3-4 days of septic shock. These changes return toward normal a week to 10 days later as the patients recover. Non-survivors as a group do not develop a decrease in ejection fraction. Individual non- survivors may develop a decreased ejection fraction but this is usually not accompanied by left ventricular dilation. The failure of the ventricle to dilate may represent an inability of the ventricle to compensate for the decrease in ejection fraction and may contribute to the patient's demise.
