Incidence Of Ventricular Dysfunction in Non-Cardiac Patients with Septic Shock and Its Effect in Short Term Mortality and Morbidity

Background: Sepsis is characterized as a subset of organ dysfunction resulting from a dysregulated host response to infection and is known to readily induce cardiomyocyte dysfunction. Objective: Determine the incidence of ventricular dysfunction and their predictive value for 30-day mortality and morbidity in non-cardiac cases admitted in the intensive care unit (ICU) with sepsis or septic shock. Methods: This prospective investigation included 100 adult cases with clinically suspected infection and features of septic shock. All cases were subjected to laboratory investigations and imaging (Electrocardiogram, Chest X-ray, Echocardiography (TTE ± TEE), 2D Doppler, Speckle tracking for LV global longitudinal strain (GLS), TAPSE and S wave for RV function, Valvular abnormalities, TEE). Results: LV systolic dysfunction was present in 40.9% of non-survivors versus only 10.7% of survivors (p<0.001), while diastolic dysfunction was also significantly higher among non-survivors (p=0.033). Similarly, right ventricular (RV) systolic dysfunction was significantly more common in non-survivors than survivors, showing a significant association (p = 0.018). Mitral regurgitation (especially moderate degrees) was strongly associated with mortality (p<0.001), Conclusions: Ventricular dysfunction is significantly associated with elevated 30-day mortality in non-cardiac ICU cases with septic shock. Over the course of follow-up, parameters such as diminished LVEF, impaired GLS, and reduced TAPSE were especially predictive of poor outcomes.