Long-Term Implications of Abnormal Left Ventricular Strain During Sepsis

Area of Science:

• Cardiology
• Critical Care Medicine
• Epidemiology

Background:

• Septic cardiomyopathy is common in sepsis and linked to short-term mortality.
• The long-term prognostic implications of septic cardiomyopathy remain unclear.

Purpose of the Study:

• To investigate the association between septic cardiomyopathy and long-term adverse cardiovascular events in sepsis survivors.
• To determine if septic cardiomyopathy predicts worse long-term outcomes post-sepsis.

Main Methods:

• Retrospective cohort study of adult ICU patients with sepsis.
• Left ventricular global longitudinal systolic strain (LVGLSS) measured as the primary indicator of septic cardiomyopathy.
• Multivariable survival analyses used to assess the association between LVGLSS and major adverse cardiovascular events (MACE) up to 24 months post-ICU discharge.

Main Results:

• Median LVGLSS was -16.8%. 38.3% of patients experienced MACE within 24 months.
• A trend towards linear association between LVGLSS and MACE (p=0.08).
• A significant nonlinear (U-shaped) association between LVGLSS and MACE was observed (p<0.001), especially in patients with pre-existing cardiac disease, younger age (<65 years), and higher Charlson Comorbidity Index (>5).

Conclusions:

• In sepsis survivors with pre-existing cardiac disease, LVGLSS shows a U-shaped association with 24-month cardiovascular outcomes.
• The prognostic impact of LVGLSS is more pronounced in younger patients with greater comorbidity burden.
• Findings may inform the design of future clinical trials for sepsis and cardiac dysfunction.