A cohort study evaluating myocardial work and right ventricle strain in sepsis in critical care

The understanding of sepsis-related changes in myocardial function is evolving. This single-centre prospective observational cohort pilot study evaluated myoCardial work and Right ventricle Strain In Sepsis (CRiSIS) with 30-day mortality in critical care patients. Measurements were recorded for 32 patients on days 1 and 3 of admission: 22 (69%) survivors and 10 (31%) non-survivors at 30 days. Survivors demonstrated a higher global work efficiency (GWE; 94%, IQR 91-96%) compared to non-survivors (88.5%, IQR 85-92%; p = 0.02, BF₁₀ = 1.44) on day 3. No significant differences in changes between day 1 and day 3 were observed in MW or RV FWS. Bayesian analysis supported a possible difference in global work index (GWI) and global constructive work (GCW) between survivors and non-survivors on day 1 and for global work index (GWI) on day 3. GWI, GCW, and GWE strongly correlated with left ventricle ejection fraction (LVEF) and global longitudinal strain (GLS), while the relationship with global wasted work (GWW) was weaker. To the best of our knowledge, this is the first study to investigate the role of MW in critically ill patients presenting with sepsis and suggests that it may be a valuable prognostic tool in this patient population.