Observational Study

. 2025 Jan;51(1):94-105.

doi: 10.1007/s00134-024-07748-2. Epub 2025 Jan 7.

Left ventricular diastolic dysfunction is prevalent but not associated with mortality in patients with septic shock

Philippe Vignon^{1

2

3}, Cyril Charron⁴, Annick Legras⁵, Frédérique Musset⁶, Michel Slama⁷, Gwenaël Prat⁸, Stein Silva⁹, David Vandroux¹⁰, Grégoire Müller¹¹, Bruno Levy¹², Florence Boissier^{13

14}, Bruno Evrard^{15

16}, Marine Goudelin^{15

16}, Stéfan Mankikian⁵, Mai-Anh Nay¹¹, Julien Jabot¹⁰, Béatrice Riu⁹, Pierre Bailly⁸, Julien Maizel⁷, Julie Léger⁶, Antoine Vieillard-Baron^{4

17

18}; CRICS-TRIGGERSEP Network

Affiliations

¹ Medical-Surgical ICU, Dupuytren University Hospital, Réanimation Polyvalente, CHU Dupuytren, Limoges, France. philippe.vignon@unilim.fr.
² Inserm CIC 1435, Dupuytren University Hospital, Limoges, France. philippe.vignon@unilim.fr.
³ Faculty of Medicine, University of Limoges, Limoges, France. philippe.vignon@unilim.fr.
⁴ Medical ICU, Assistance Publique-Hôpitaux de Paris, University Hospital Ambroise Paré, Boulogne-Billancourt, France.
⁵ Medical ICU, Bretonneau University Hospital, Tours, France.
⁶ Inserm CIC 1415, Bretonneau University Hospital, Tours, France.
⁷ Medical ICU, Amiens University Hospital, Amiens, France.
⁸ Medical ICU, Cavale Blanche University Hospital, Brest, France.
⁹ Medical-Surgical ICU, Purpan Teaching Hospital, Toulouse, France.
¹⁰ Medical-Surgical ICU, La Réunion University Hospital, Saint-Denis-de-La-Réunion, France.
¹¹ Medical-Surgical ICU, Orléans Teaching Hospital, Orléans, France.
¹² Medical ICU, Brabois Teaching Hospital and Inserm U-1116, Nancy, France.
¹³ Medical ICU, University Hospital of Poitiers, Poitiers, France.
¹⁴ Inserm CIC 1402 (IS-ALIVE Group), University of Poitiers, Poitiers, France.
¹⁵ Medical-Surgical ICU, Dupuytren University Hospital, Réanimation Polyvalente, CHU Dupuytren, Limoges, France.
¹⁶ Inserm CIC 1435, Dupuytren University Hospital, Limoges, France.
¹⁷ Inserm U-1018, CESP, Team 5, University of Versailles Saint-Quentin en Yvelines, Villejuif, France.
¹⁸ Faculty of Medicine Paris Ile-de-France Quest, University of Versailles Saint-Quentin en Yvelines, Villejuif, France.

PMID: 39774865
DOI: 10.1007/s00134-024-07748-2

Observational Study

Left ventricular diastolic dysfunction is prevalent but not associated with mortality in patients with septic shock

Philippe Vignon et al. Intensive Care Med. 2025 Jan.

. 2025 Jan;51(1):94-105.

doi: 10.1007/s00134-024-07748-2. Epub 2025 Jan 7.

Authors

Affiliations

¹ Medical-Surgical ICU, Dupuytren University Hospital, Réanimation Polyvalente, CHU Dupuytren, Limoges, France. philippe.vignon@unilim.fr.
² Inserm CIC 1435, Dupuytren University Hospital, Limoges, France. philippe.vignon@unilim.fr.
³ Faculty of Medicine, University of Limoges, Limoges, France. philippe.vignon@unilim.fr.
⁴ Medical ICU, Assistance Publique-Hôpitaux de Paris, University Hospital Ambroise Paré, Boulogne-Billancourt, France.
⁵ Medical ICU, Bretonneau University Hospital, Tours, France.
⁶ Inserm CIC 1415, Bretonneau University Hospital, Tours, France.
⁷ Medical ICU, Amiens University Hospital, Amiens, France.
⁸ Medical ICU, Cavale Blanche University Hospital, Brest, France.
⁹ Medical-Surgical ICU, Purpan Teaching Hospital, Toulouse, France.
¹⁰ Medical-Surgical ICU, La Réunion University Hospital, Saint-Denis-de-La-Réunion, France.
¹¹ Medical-Surgical ICU, Orléans Teaching Hospital, Orléans, France.
¹² Medical ICU, Brabois Teaching Hospital and Inserm U-1116, Nancy, France.
¹³ Medical ICU, University Hospital of Poitiers, Poitiers, France.
¹⁴ Inserm CIC 1402 (IS-ALIVE Group), University of Poitiers, Poitiers, France.
¹⁵ Medical-Surgical ICU, Dupuytren University Hospital, Réanimation Polyvalente, CHU Dupuytren, Limoges, France.
¹⁶ Inserm CIC 1435, Dupuytren University Hospital, Limoges, France.
¹⁷ Inserm U-1018, CESP, Team 5, University of Versailles Saint-Quentin en Yvelines, Villejuif, France.
¹⁸ Faculty of Medicine Paris Ile-de-France Quest, University of Versailles Saint-Quentin en Yvelines, Villejuif, France.

PMID: 39774865
DOI: 10.1007/s00134-024-07748-2

Abstract

Purpose: Prognostic impact of left ventricular diastolic dysfunction (LVDD) in septic shock patients has not been determined using current diagnostic guidelines. We assessed the relation between LVDD during the first 3 days following intensive care unit (ICU) admission for septic shock and Day-28 mortality.

Methods: This prospective, multicenter, observational study enrolled 402 patients (age: 63 ± 13 year; 59% male; SAPS II: 59 ± 20; SOFA: 9.4 ± 3.6; mechanical ventilation: 74%) with septic shock (Sepsis-3 definition). Patients were echocardiographically assessed within 12 h after admission (Day 1), on Day 2, Day 3, at ICU and at hospital discharge (or Day 28 whichever occurred first), using 2016 American-European guidelines.

Results: LVDD was present at least once between Day 1 and 3 in 304 patients (76%), and in 56% and 44% of patients at ICU discharge and on Day 28 (or hospital discharge), respectively (43% of patients with follow-up). Seventy-eight of 172 patients (45%) exhibited similar LV diastolic properties throughout the study period while 58 patients (34%) improved their LVDD at follow-up (lower grade: n = 9, regression: n = 49). Day-28 mortality was not statistically different between patients with and without LVDD (80/304 [26%] vs. 25/88 [28%]; OR: 0.900 [0.530-1.527]; p = 0.696). Similar results were obtained when adjusting the multivariate model on SAPSII or SOFA score on admission, together with fluid balance during the first three days of ICU stay (OR: 0.838 [0.471-1.491]: p = 0.547 and OR: 0.887 [0.513-1.534]: p = 0.668, respectively).

Conclusion: LVDD was highly prevalent in patients with septic shock but not associated with mortality. It appeared improving in one-third of survivors.

Trial registration: PRODIASYS study registered on ClinicalTrials (September 27, 2016, number NCT02918214).

Keywords: Left ventricular diastolic function; Prognosis; Sepsis; Septic shock.

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Conflict of interest statement

Declarations. Conflicts of interest: Authors declare having no financial or non-financial conflict of interest related to the work submitted for publication. Ethics approval: The study protocol was approved by the ethics commitee (CPP16-045/2016-A00100-51).

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Left ventricular diastolic dysfunction is prevalent but not associated with mortality in patients with septic shock

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Left ventricular diastolic dysfunction is prevalent but not associated with mortality in patients with septic shock

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