Types of Septic Cardiomyopathy: Prognosis and Influencing Factors - A Clinical Study

Nian-Fang Lu; Hong-Xia Niu; An-Qi Liu; Ya-Lei Chen; Hu-Nan Liu; Pei-Hong Zhao; Jun Shao; Xiu-Ming Xi

doi:10.2147/RMHP.S452803

Types of Septic Cardiomyopathy: Prognosis and Influencing Factors - A Clinical Study

Risk Manag Healthc Policy. 2024 Apr 23:17:1015-1025. doi: 10.2147/RMHP.S452803. eCollection 2024.

Authors

Nian-Fang Lu¹, Hong-Xia Niu², An-Qi Liu¹, Ya-Lei Chen¹, Hu-Nan Liu¹, Pei-Hong Zhao¹, Jun Shao³, Xiu-Ming Xi⁴

Affiliations

¹ Department of Critical Care Medicine, Capital Medical University Electric Teaching Hospital/Beijing Electric Power Hospital, Beijing, People's Republic of China.
² Department of Emergency, Capital Medical University Electric Teaching Hospital/Beijing Electric Power Hospital, Beijing, People's Republic of China.
³ Department of Critical Care Medicine, Subei People's Hospital of Jiangsu Province, Yangzhou, People's Republic of China.
⁴ Department of Critical Care Medicine, Capital Medical University Fuxing Hospital, Beijing, People's Republic of China.

Abstract

Objective: To explore the prognostic outcomes associated with different types of septic cardiomyopathy and analyze the factors that exert an influence on these outcomes.

Methods: The data collected within 24 hours of ICU admission included cardiac troponin I (cTnI), N-terminal pro-Brain Natriuretic Peptide (NT-proBNP); SOFA (sequential organ failure assessment) scores, and the proportion of vasopressor use. Based on echocardiographic outcomes, septic cardiomyopathy was categorized into left ventricular (LV) systolic dysfunction, LV diastolic dysfunction, and right ventricular (RV) systolic dysfunction. Differences between the mortality and survival groups, as well as between each cardiomyopathy subgroup and the non-cardiomyopathy group were compared, to explore the influencing factors of cardiomyopathy.

Results: A cohort of 184 patients were included in this study, with LV diastolic dysfunction having the highest incidence rate (43.5%). The mortality group had significantly higher SOFA scores, vasopressor use, and cTnI levels compared to the survival group; the survival group had better LV diastolic function than the mortality group (p < 0.05 for all). In contrast to the non-cardiomyopathy group, each subgroup within the cardiomyopathy category exhibited elevated levels of cTnI. The subgroup with left ventricular diastolic dysfunction demonstrated a higher prevalence of advanced age, hypertension, diabetes mellitus, coronary artery disease, and an increased mortality rate; the RV systolic dysfunction subgroup had higher SOFA scores and NT-proBNP levels, and a higher mortality rate (P < 0.05 for all); the LV systolic dysfunction subgroup had a similar mortality rate (P > 0.05).

Conclusion: Patients with advanced age, hypertension, diabetes mellitus, or coronary artery disease are more prone to develop LV diastolic dysfunction type of cardiomyopathy; cardiomyopathy subgroups had higher levels of cTnI. The RV systolic dysfunction cardiomyopathy subgroup had higher SOFA scores and NT-proBNP levels. The occurrence of RV systolic dysfunction in patients with sepsis significantly increased the mortality rate.

Keywords: cardiac function; echocardiography; influencing factors; prognosis; sepsis; septic cardiomyopathy.

Grants and funding

This work was supported by Scientific Research Project of Jiangsu Commission of Health of the People’s Republic of China (grant number: Z2020055), and the Ministry of Science and Technology of the People’s Republic of China (grant number: 2012BAI11B05).