Prognostic Implications of Elevated Left Ventricular Ejection Fraction in Patients with Sepsis

Area of Science:

• Cardiology
• Critical Care Medicine
• Echocardiography

Background:

• Left ventricular systolic function is a debated prognostic marker in sepsis.
• Assessing left ventricular ejection fraction (LVEF) in sepsis patients is crucial for understanding mortality risk.

Purpose of the Study:

• To evaluate the association between different levels of left ventricular ejection fraction (LVEF) and mortality outcomes in sepsis patients.
• To determine if LVEF is a significant predictor of 28-day mortality in intensive care unit (ICU) sepsis patients.

Main Methods:

• Retrospective, single-center longitudinal cohort study of ICU-admitted adult sepsis patients.
• Transthoracic echocardiography (TTE) performed within seven days of ICU admission.
• Patients stratified into hyperdynamic (LVEF ≥70%), normal (LVEF 55%-70%), and depressed (LVEF ≤55%) LVEF groups.

Main Results:

• Among 3,363 patients, hyperdynamic LVEF was the strongest predictor of 28-day mortality.
• Hyperdynamic LVEF was independently associated with a 3.643-fold higher hazard of death compared to normal LVEF.
• A significant link exists between hyperdynamic left ventricular function and elevated 28-day mortality in ICU sepsis patients.

Conclusions:

• Hyperdynamic left ventricular function is a significant independent predictor of increased 28-day mortality in sepsis patients admitted to the ICU.
• Enhanced clinical awareness of hyperdynamic LVEF in sepsis is warranted due to its prognostic implications.
• This study emphasizes the critical role of echocardiographic assessment in stratifying risk for sepsis patients.