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Hemodynamic Changes, Organ Dysfunction, and Clinical Outcomes in Patients With Sepsis-Induced Myocardial Dysfunction.

Xu-Dong Shen1, De-Yu Meng2, Yue-Hong Yin3

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Shock (Augusta, Ga.)
|September 17, 2025
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Summary

Sepsis-induced myocardial dysfunction (SIMD) is linked to worse outcomes, including organ dysfunction and higher mortality. Elevated BNP and troponin I levels predict septic shock in these patients.

Keywords:
Clinical outcomeshemodynamicsmyocardial dysfunctionorgan dysfunctionsepsis

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Area of Science:

  • Cardiology
  • Critical Care Medicine
  • Internal Medicine

Background:

  • Sepsis-induced myocardial dysfunction (SIMD) is a critical complication of sepsis.
  • Understanding its hemodynamic impact and clinical consequences is vital for patient management.

Purpose of the Study:

  • To investigate hemodynamic changes in SIMD.
  • To assess SIMD's impact on organ dysfunction and clinical outcomes.
  • To identify predictors of septic shock in SIMD patients.

Main Methods:

  • A cohort of 170 sepsis patients were divided into sepsis without myocardial dysfunction (n=106) and SIMD (n=64) groups.
  • Hemodynamic parameters, organ dysfunction markers, and clinical outcomes were compared.
  • Multivariate analysis identified risk factors for septic shock.

Main Results:

  • SIMD patients were older with higher APACHE II scores and elevated central venous pressure and dp/dt max.
  • Higher incidence of multiple organ dysfunction, prolonged mechanical ventilation, longer ICU stays, and increased mortality were observed in the SIMD group.
  • APACHE II scores, troponin I (TnI), and B-type natriuretic peptide (BNP) were independent risk factors for septic shock; BNP was the strongest predictor.

Conclusions:

  • SIMD is associated with significant hemodynamic disturbances, increased respiratory dysfunction, and adverse clinical outcomes, including higher mortality.
  • Elevated BNP and cTnI levels in SIMD patients indicate a heightened risk of septic shock and multiorgan dysfunction.
  • BNP levels can effectively predict septic shock in patients with SIMD.