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Related Concept Videos

Mitral Stenosis I: Introduction01:22

Mitral Stenosis I: Introduction

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Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
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Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

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Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
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Mitral Regurgitation I: Introduction01:20

Mitral Regurgitation I: Introduction

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Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
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Heart Failure III: Clinical Manifestations01:26

Heart Failure III: Clinical Manifestations

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Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...
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Pathophysiology of Heart Failure01:17

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Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
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Aortic Regurgitation II: Clinical Features and Diagnostic Tests01:22

Aortic Regurgitation II: Clinical Features and Diagnostic Tests

51
Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
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Association Between Initial Left Ventricular Systolic Dysfunction and Clinical Outcome in Sepsis: A Multicenter

Hyunseung Nam1, Ji Hyun Cha1, Ki Hong Choi2

  • 1Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.

Critical Care Medicine
|July 2, 2025
PubMed
Summary

Severe left ventricular (LV) systolic dysfunction in sepsis patients significantly increases in-hospital mortality, especially with bacteremia or no prior cardiovascular disease. Early cardiac assessment is crucial for sepsis management.

Keywords:
bacteremiacardiomyopathyejection fractionleft ventricular dysfunctionmortalitysepsis

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Area of Science:

  • Cardiology
  • Critical Care Medicine
  • Infectious Diseases

Background:

  • Sepsis is a life-threatening organ dysfunction caused by dysregulated host response to infection.
  • Left ventricular (LV) systolic dysfunction is a common complication in sepsis.
  • The impact of LV dysfunction severity on clinical outcomes in sepsis requires further investigation.

Purpose of the Study:

  • To examine the association between the severity of LV systolic dysfunction and clinical outcomes in sepsis patients.
  • To specifically focus on in-hospital mortality as a primary outcome.

Main Methods:

  • A multicenter cohort study involving 2274 adult sepsis patients from 19 hospitals in South Korea.
  • Echocardiography was performed within 24 hours of sepsis recognition to assess LV ejection fraction (LVEF).
  • Patients were stratified into normal (>50%), mild-to-moderate (30-50%), and severe (<30%) LVEF groups.

Main Results:

  • In-hospital mortality rates were 25.73% (normal LVEF), 29.49% (mild-to-moderate), and 40.00% (severe LVEF) (p=0.023).
  • Severe LV dysfunction was independently associated with increased in-hospital mortality (aOR 1.81) after propensity score matching.
  • This association was stronger in patients without pre-existing cardiovascular disease and those with bacteremia.

Conclusions:

  • Severe LV systolic dysfunction (LVEF < 30%) is a significant predictor of increased in-hospital mortality in sepsis.
  • The presence of bacteremia and absence of pre-existing cardiovascular disease exacerbate this risk.
  • Early assessment of cardiac function in sepsis is vital, as infection status and cardiovascular health influence outcomes.