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Characterisation of Post-Sepsis Cardiomyopathy Using Cardiovascular Magnetic Resonance

Samuel Malomo1, Thomas Oswald1, Edward Stephenson1

  • 1Sussex Cardiac Centre, Royal Sussex County Hospital, Brighton BN2 5BE, UK.

Diagnostics (Basel, Switzerland)
|May 1, 2025
PubMed

Insights

Post-sepsis cardiomyopathy often involves left ventricular (LV) enlargement and dysfunction, with evidence of myocardial fibrosis but not significant edema weeks after sepsis recovery. This understanding is crucial for developing new treatments for this condition.

Area of Science:

  • Cardiology
  • Intensive Care Medicine
  • Medical Imaging

Background:

  • Post-sepsis cardiomyopathy (PSC) is linked to poor cardiovascular outcomes but is poorly understood, hindering therapeutic development.
  • Characterizing PSC is essential for advancing treatment strategies and improving patient prognosis.
  • Cardiovascular magnetic resonance (CMR) imaging offers a detailed method for assessing cardiac structure and function in PSC.

Purpose of the Study:

  • To characterize the cardiac manifestations of post-sepsis cardiomyopathy (PSC) using cardiovascular magnetic resonance (CMR) imaging.
  • To investigate the presence of myocardial fibrosis and edema in patients recovering from sepsis.
  • To provide insights into the pathophysiology of PSC for future therapeutic interventions.

Main Methods:

  • A cohort of 22 patients with acute sepsis and suspected cardiac injury underwent CMR (cines, T1/T2-mapping, LGE) 47 days (IQR: 22-122) post-admission.
  • Age- and gender-matched healthy controls (n=16) were included for comparison.
  • CMR parameters assessed included left ventricular (LV) volumes, ejection fraction, and myocardial tissue characterization (native T1/T2, LGE).

Main Results:

  • 59% of post-sepsis patients exhibited left ventricular (LV) dilatation with significantly elevated LV volumes compared to controls.
  • 50% of patients had LV systolic dysfunction (ejection fraction < 50%), with most showing non-ischaemic late gadolinium enhancement (LGE).
  • Elevated septal native T1 values indicated myocardial fibrosis, while similar T2 values suggested minimal myocardial edema weeks post-sepsis.

Conclusions:

  • Post-sepsis cardiomyopathy is characterized by LV dilatation, systolic dysfunction, and non-ischaemic myocardial fibrosis.
  • Significant myocardial edema is not a prominent feature several weeks after sepsis recovery.
  • Further multi-center studies are required to validate these findings and develop targeted therapies for PSC.

Keywords:
cardiomyopathycardiovascular imagingcardiovascular magnetic resonanceheart failuresepsis

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