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. 2018 Feb;49(2):144-149.
doi: 10.1097/SHK.0000000000000952.

New-Onset Heart Failure and Mortality in Hospital Survivors of Sepsis-Related Left Ventricular Dysfunction

Saraschandra Vallabhajosyula  1   2   3   4 , Jacob C Jentzer  1   2 , Jeffrey B Geske  1 , Mukesh Kumar  3   5 , Ankit Sakhuja  2 , Akhil Singhal  3   5 , Joseph T Poterucha  2 , Kianoush Kashani  2   3   6 , Joseph G Murphy  1 , Ognjen Gajic  2   3 , Rahul Kashyap  3   5
Affiliations

New-Onset Heart Failure and Mortality in Hospital Survivors of Sepsis-Related Left Ventricular Dysfunction

Saraschandra Vallabhajosyula et al. Shock. 2018 Feb.

Abstract

Background: The association between new-onset left ventricular (LV) dysfunction during sepsis with long-term heart failure outcomes is lesser understood.

Methods: Retrospective cohort study of all adult patients with severe sepsis and septic shock between 2007 and 2014 who underwent echocardiography within 72 h of admission to the intensive care unit. Patients with prior heart failure, LV dysfunction, and structural heart disease were excluded. LV systolic dysfunction was defined as LV ejection fraction <50% and LV diastolic dysfunction as ≥grade II. Primary composite outcome included new hospitalization for acute decompensated heart failure and all-cause mortality at 2-year follow-up. Secondary outcomes included persistent LV dysfunction, and hospital mortality and length of stay.

Results: During this 8-year period, 434 patients with 206 (48%) patients having LV dysfunction were included. The two groups had similar baseline characteristics, but those with LV dysfunction had worse function as demonstrated by worse LV ejection fraction, cardiac index, and LV diastolic dysfunction. In the 331 hospital survivors, new-onset acute decompensated heart failure hospitalization did not differ between the two cohorts (15% vs. 11%). The primary composite outcome was comparable at 2-year follow-up between the groups with and without LV dysfunction (P = 0.24). Persistent LV dysfunction was noted in 28% hospital survivors on follow-up echocardiography. Other secondary outcomes were similar between the two groups.

Conclusions: In patients with severe sepsis and septic shock, the presence of new-onset LV dysfunction did not increase the risk of long-term adverse heart failure outcomes.

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Conflict of interest statement

CONFLICTS OF INTEREST

All authors report no financial or intellectual conflicts of interest related to this manuscript.

Figures

Figure 1
Figure 1. Study population
*Individual percentages are not additive due to multiplicity of exclusion criteria Represented as: Number (Percentage) Abbreviations: HD: heart disease; HF: heart failure; LV: left ventricular; VHD: valvular heart disease
Figure 2
Figure 2. Primary outcome for hospital survivors with and without LV dysfunction*
p=0.24 by log-rank test *Composite outcome of new-onset acute decompensated heart failure and all-cause mortality Abbreviations: LV: left ventricular
See this image and copyright information in PMC

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