Cardiology Letters 2024, 33(2):83-90

Cardiac dysfunction in septic conditions: Insights from echocardiographic evaluation and mortality associations

Frantisek Golas¹, Rastislav Cikrai², Jurina Sadlonova³, Milan Dragula³, Monika Kulinova⁴, Andrea Cikraiova⁴

¹ The Jessenius Faculty of Medicine in Martin, Comenius University Bratislava, Hospital with Policlinic, Department of Internal Medicine, Zilina, Slovakia

² Faculty of Medicine of the Comenius University, National Institute of Cardiovascular Diseases, Clinic of Cardiac Surgery, Bratislava, Slovakia

³ The Jessenius Faculty of Medicine in Martin, Comenius University, University Hospital Martin, Cardiology department, Martin, Slovakia

⁴ Hospital with Policlinic, Department of Internal Medicine, Zilina, Slovakia

Introduction: In septic cardiomyopathy, changes manifest as systolic and diastolic dysfunction of both the left and right ventricles and dilation of cardiac chambers. The aim of this study was to determine whether left ventricular dysfunction as well as the right ventricular dysfunction were associated with 30-day mortality.

Patients and methods: Using established criteria for sepsis and septic shock (SEPSIS.3, The third international consensus definitions for sepsis and septic shock, SOFA score), a total of 65 patients (41 males, 24 females) were enrolled for observation from January 1, 2020, to January 1, 2023. The overall mean age of the patients was 62.5±15.2 years old. Subsequently, transthoracic and, if necessary, transesophageal echocardiographic examinations were performed.

Results: Systolic dysfunction (EF ≤ 55%) was observed in 35/65 (53.8%) patients on the first day of observation. Comparison using the log-rank test did not show a significant difference in survival time between patients with EF ≤ 55% and those with EF > 55%. Diastolic left ventricle dysfunction (LV) was present in 50/65 (76.9%) patients on the first examination day. We confirmed a strong association between diastolic dysfunction of the LV and mortality. Right ventricular (RV) dysfunction was present in 22/65 (33.8%) patients on the first day. RV dysfunction was significantly associated with higher mortality compared to the control group.

Conclusion: In our study, we investigated the relationship between systolic and diastolic dysfunction of the left ventricle (LV), as well as the systolic dysfunction of the right ventricle (RV) in patients with sepsis/septic shock, focusing on the 30-day mortality rate. We identified a significant association between left ventricular diastolic dysfunction and 30-day mortality. Similarly, right ventricular systolic dysfunction was significantly correlated with 30-day mortality. Conversely, left ventricular systolic dysfunction (EF ≤ 55%) did not demonstrate an impact on 30-day mortality compared to patients with preserved left ventricular systolic function (EF > 55%).

Kľúčové slová: sepsis; systolic dysfunction; diastolic dysfunction; echocardiography

Uverejnené: February 1, 2024  Zobraziť citáciu