Characteristics associated with left ventricular diastolic dysfunction and its prognostic implication in patients...

To identify risk factors and characteristics associated with left ventricular diastolic dysfunction and investigate its correlation with mortality in sepsis patients.

A prospective cohort study was performed in sepsis patients between December 2022 and October 2023. Baseline characteristics, laboratory tests, treatments, echocardiographic results, and 28-day mortality were documented. Univariate and multivariate logistic regression analyses were conducted and a nomogram was constructed. Association between left ventricular diastolic dysfunction and 28-day mortality was analyzed.

In total, 117 patients with a mean age of 58.3 ± 16.5 years old and 63.3% men (74) were included. There were 75 (64.1%) and 42 (36.9%) patients with abnormal and normal diastolic dysfunction, respectively. Pneumonia, hematocrit, the ratio of E-wave peak velocity to A-wave peak velocity (E/A), ventricular septal early diastolic peak velocity of the mitral valve annulus (e'), and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels were associated with ventricular diastolic dysfunction (P < 0.05). The nomogram constructed with these variables demonstrated high accuracy in predicting the occurrence of left ventricular diastolic dysfunction (area under the curve 0.938, sensitivity 83.8%, specificity 97.6%, Youden index 0.814). Left ventricular diastolic dysfunction could cause an increased 28-day mortality, with grade III diastolic dysfunction having the highest mortality rate (40.0%).

In sepsis patients, a nomogram based on pneumonia, hematocrit, E/A, ventricular septal e', and NT-proBNP levels could accurately assess left ventricular diastolic dysfunction. Left ventricular diastolic dysfunction was associated with a high 28-day mortality, warranting further studies on the association between dysfunction severity and mortality risk.