Incidence and evolution of sepsis-induced cardiomyopathy in a cohort of patients with sepsis and septic shock

Abstract

Objetive: The aim of this study was to establish the incidence of septic cardiomyopathy (SM) in patients with sepsis and septic shock, to describe its characteristics and testing its evolution.

Design: Prospective cohort study.

Participants: We included 57 consecutive patients admitted to Intensive Care Unit, who met criteria of sepsis and septic shock.

Principal variables of interest: Clinical and biochemical variables were analyzed. An echocardiogram was performed in the first 24hours of admission, determining myocardial function parameters, and if the patients had left ventricular ejection fraction (LVEF)<50%) a second echocardiogram was performed.

Ambit: Intensive medical and surgical Care Service for Adults in University Hospital.

Results: The mean age of the patients was 62,1±16,3 years. 58% were males. 22.8% had left ventricular dysfunction. The mean LVEF in patients with MS was lower than those without SM (34.1±10.6 vs 60.7±6.94%, P<.001), with complete recovery, in survivors, after the acute event (LVEF at discharge 56.1±6.3%, P=.04). Patients with SM had higher levels of procalcitonin (47.1±35.4 vs 18.9±24.5; P=.02) and higher score on the Sequential Organ Failure Assessment (SOFA score) (9.91±3.82 vs 7.47±3.41; P=.037). Mortality was not significantly different between both groups [4 (30.8%) vs 4 (9.1%); P=.07].

Conclusions: SM is not uncommon and is related to a higher scores on the severity scales. In the survivors, LVEF normalized after the recovery of the acute event.

Keywords: Fracción de eyección del ventrículo izquierdo); Left ventricular ejection fraction; Miocardiopatía séptica; Sepsis; Septic cardiomyopathy sepsis; Septic shock; Shock séptico.