Prognostic Implications of Elevated Left Ventricular Ejection Fraction in Patients with Sepsis

The role of left ventricular systolic function as a prognostic marker for sepsis patients remains an area of ongoing research and debate. The present investigation exhibited the comprehensive evaluation of the relationship between different levels of left ventricular ejection fraction (LVEF) and mortality outcomes in sepsis-diagnosed patients. A retrospective, single-center longitudinal cohort investigation was conducted involving the intensive care unit (ICU) admitted adults' patients at Beth Israel Deaconess Medical Center who underwent transthoracic echocardiography (TTE) during their hospitalization. Individuals diagnosed with sepsis and who received Doppler echocardiography were included in the analysis if transthoracic echocardiography was performed within seven days of ICU admission. All patients of age below 18 or above 90 years, a prior history of cardiac disease or cardiac surgery, and those for whom echocardiography was performed more than seven days after ICU admission were excluded. Patients were stratified into three distinct groups with relation to their LVEF levels: hyperdynamic (LVEF ≥70%), normal (LVEF 55%-70%), and depressed (LVEF ≤55%). The association between different categories of sepsis affected patients mortality outcome and left ventricular ejection fraction (LVEF) was assessed. Among the 3,363 patients analyzed, comprising 1,175 with decreased LVEF, 2,119 with normal LVEF, and 68 with hyperdynamic LVEF, multivariate Cox regression identified hyperdynamic function as the strongest predictor of 28-day mortality. Specifically, hyperdynamic LVEF was independently linked to a 3.643-fold higher hazard of death relative to the normal LVEF group. A significant link has been identified between hyperdynamic left ventricular function and elevated 28-day mortality rates in the ICU-admitted septic patients. This physiological condition underscores the need for enhanced clinical awareness due to its prognostic significance.