Impact of Bi-ventricular Systolic Function on Mortality in Patients with Sepsis and Septic Shock

Elif Tükenmez Tigen1, Alper Kepez2, Murat Sünbül2, Beste Özben2, Buket Ertürk Şengel1, Beliz Bilgili3, Şehnaz Olgun Yıldızeli4, Kürşat Tigen2

1Department of Infectious Diseases and Clinical Microbiology, University of Marmara Pendik Training and Research Hospital, Istanbul, Turkey
2Department of Cardiology, University of Marmara Pendik Training and Research Hospital, Istanbul, Turkey
3Department of Anesthesiology and Reanimation, University of Marmara Pendik Training and Research Hospital, Istanbul, Turkey
4Department of Chest Diseases, University of Marmara Pendik Training and Research Hospital, Istanbul, Turkey

Keywords: Mortality; left ventricular function; right ventricular function; sepsis

Abstract

Introduction: We aimed to evaluate left ventricular (LV) and right ventricular (RV) systolic performance in patients with sepsis or septic shock and possible functional alteration on in-hospital mortality.
Patients and Methods: Thirty-seven consecutive patients with the diagnosis of sepsis or septic shock were included in the study. All patients underwent comprehensive transthoracic echocardiographic examination. Data of patients discharged from the intensive care unit was compared with data of patients who died in the hospital.
Results: Fifteen patients (40.5%) survived, while 22 patients were died in the hospital (59.5%). A significant difference was detected between survivor and non-survivor groups regarding before discharge or death level of inflammatory markers such as CRP (p= 0.05) and procalcitonin (p= 0.03) besides BNP (p= 0.01) and SOFA (p= 0.009) score. There were two patients (5.4%) with EF value less than %50 in the study population. Eight patients (21.6%) displayed hypokinesia on the apical segment, and four patients (10.8%) had TAPSE values below 17 mm. One patient (6.6%) in the survivor group, but seven patients (31.8%) in the non-survivor group had apical hypokinesia with a trend towards significance (p= 0.068). One patient in the survivor group (6.6%) and three patients (13.6%) in the non-survivor group had RV systolic dysfunction (p= 0.51).
Conclusion: We found a much lower rate of LV and RV systolic dysfunction in patients with sepsis or septic shock compared with previous studies. None of the myocardial dysfunction types was associated with in-hospital mortality. Apical hypokinesia was also more prevalent in non-survivors despite borderline significance.

Ethics Committee Approval

The approval for this study was obtained from Marmara University Hospital Ethics Committee (Decision No: 09.2021.559, Date: 26.05.2021).

Peer Review

Externally peer-reviewed.

Author Contributions

Concept/Design - ET, AK; Analysis/Interpretation - AK, MS, AK, BŞ, ŞY; Data Collection - ET, AK, BŞ, ŞY, BB; Writing - AK, ET, MS; Critical Revision - KT; Statistical Analysis - BO; Overall Responsibility - ET; Final Approval - All of Authors.

Conflict of Interest

The authors have no conflicts of interest to declare.

Financial Disclosure

The authors declared that this study has received no financial support.