Högerkammarstrain hos patienter med septiskchock och dess samband med kliniska utfall

Background Right ventricular (RV) dysfunction is common in septic shock and worsens outcome. Strainechocardiography, especially RV free wall strain (FWS), is a sensitive method for detectingsubclinical myocardial dysfunction. However, their prognostic value in sepsis remains unclear. AimThe aim of this study was to investigate the association between RV-FWS and 30-day mortalityin patients with septic shock. Secondary objectives were to assess associations with intensiveunit care (ICU) mortality, organ support free days (OSFD), and myocardial injury. Methods Data from the Sepsis in the ICU study (SICU-2) was used for this project. Adult patients withseptic shock within 12 hours of ICU admission were included. Within 24 hours, transthoracicechocardiography was performed and RV-FWS was assessed using speckle trackingechocardiography. Abnormal RV-FWS was defined as > –20%. Outcomes included 30-daymortality, ICU mortality, OSFD, and myocardial injury (hsTnT >45 ng/L). Logistic regressionwas adjusted for age and sex. Results Of 261 patients, 72 (27.6%) had analyzable RV-FWS data. Median RV-FWS was –18.25%, and59.7% had abnormal strain. RV-FWS did not significantly differ between 30-day survivors andnon-survivors (p = 0.365), nor was abnormal RV-FWS independently associated with 30-daymortality (OR 1.31, 95% CI 0.40–4.27; p = 0.651). No differences were found for ICU mortalityor OSFD. However, abnormal RV-FWS was significantly associated with myocardial injury(74.3% vs. 50.0%; p = 0.040). Conclusion Abnormal RV-FWS was not associated with 30-day mortality or organ support but wasassociated with myocardial injury. RV-FWS may serve as a marker of subclinical cardiacdysfunction in sepsis.