| Abstract [eng] |
Cardiovascular impairment is a common complication of sepsis, and septic cardiomyopathy is defined as an acute, reversible cardiac dysfunction caused by a systemic inflammatory response to infection. Traditionally, the diagnosis of this condition is based on the assessment of left ventricular ejection fraction (LVEF), which remains the most commonly used parameter in clinical practice. Aim. To evaluate the prevalence of septic cardiomyopathy, as well as hemodynamic and clinical characteristics and 28-day mortality risk, among patients with sepsis and septic shock treated in the intensive care unit. Objectives: 1. To review recent literature on the definition, prevalence, pathophysiology, and diagnostic methods of septic cardiomyopathy. 2. To analyze echocardiographic and hemodynamic data and to determine the prevalence of septic cardiomyopathy in the study population based on LVEF. 3. To compare differences in hemodynamic, laboratory, and clinical parameters between patient groups stratified by LVEF values. 4. To evaluate 28-day mortality among patients diagnosed with septic cardiomyopathy. Methods. A prospective observational study was conducted at Vilnius University Hospital Santaros Clinics from September 2024 to October 2025. Transthoracic echocardiography was performed within 48 hours of enrollment in patients who met the inclusion criteria. Septic cardiomyopathy was defined as reduced LVEF (LVEF <50% or ≥10% decrease from baseline). To analyze difference in hemodynamic and clinical parameters, patients were divided into two groups according to LVEF: LVEF ≥50% and LVEF <50% or ≥10% decrease from baseline. 28-day mortality was calculated using a binary logistic regression model. Statistical analysis was performed using IBM SPSS software (version 31.0.1.0). Results. 78 patients were included in the study. Septic shock was diagnosed in 63 (80.8%) patients. Based on LVEF, septic cardiomyopathy was identified in 16 (20.5%) cases. Patients with reduced LVEF had significantly higher diastolic pressure (P=0.03), systemic vascular resistance (P=0.04), and troponin I concentration (P=0.002), while other hemodynamic and clinical parameters did not differ significantly between groups. Patients with impaired left ventricular systolic function had a higher risk of 28-day mortality (OR=1.58). However, this difference did not reach statistical significance (P=0.415). Conclusions. Septic cardiomyopathy, assessed using LVEF, was identified in approximately one-fifth of patients with sepsis and septic shock. However, the prognostic value of this parameter for 28-day mortality was not confirmed in this study. Compared with literature data, our findings suggest that evaluation based solely on LVEF may be insufficient, and its prognostic value remains debatable, reflecting the complexity of this condition. |
