Patterns of left and right ventricular dysfunction and their clinical outcomes in septic patients

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Publicado en:BMC Anesthesiology vol. 25 (2025), p. 1-11
Autor principal: Zhang, Hongmin
Otros Autores: Gao, Beijun, Liu, Ye, Zhang, Qing, Wang, Xiaoting
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Springer Nature B.V.
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Acceso en línea:Citation/Abstract
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LEADER 00000nab a2200000uu 4500
001 3236998811
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022 |a 1471-2253 
024 7 |a 10.1186/s12871-025-03233-5  |2 doi 
035 |a 3236998811 
045 2 |b d20250101  |b d20251231 
084 |a 58454  |2 nlm 
100 1 |a Zhang, Hongmin 
245 1 |a Patterns of left and right ventricular dysfunction and their clinical outcomes in septic patients 
260 |b Springer Nature B.V.  |c 2025 
513 |a Journal Article 
520 3 |a Section BackgroundTo investigate the various types of left ventricular (LV) and right ventricular (RV) dysfunction and their association with clinical outcomes in septic patients.AbstractSection MethodsWe retrospectively reviewed a cohort of sepsis and septic shock patients admitted to a tertiary hospital intensive care unit (ICU). Left ventricular dysfunction was determined by left ventricular ejection fraction (LVEF). Right ventricular systolic dysfunction (RVSD) was determined by tricuspid annular plane systolic excursion (TAPSE), fractional area change (FAC), or RV S’ velocity. Cardiac function was categorized into five types: (1) normal cardiac function (LVEF > 50% but ≤ 70%, TAPSE ≥ 17 mm, RV FAC ≥ 35%, and RV S’ ≥9.5 cm/sec); (2) biventricular dysfunction (LVEF ≤ 50%, TAPSE < 17 mm or RV FAC < 35% or RV S’ < 9.5 cm/sec); (3) isolated LV dysfunction (LVEF ≤ 50%, TAPSE ≥ 17 mm, RV FAC ≥ 35%, and RV S’ ≥9.5 cm/sec); (4) isolated RV dysfunction (LVEF > 50%, TAPSE < 17 mm or RV FAC < 35% or RV S’ < 9.5 cm/sec); and (5) hyperdynamic LV function (LVEF > 70%, TAPSE ≥ 17 mm, RV FAC ≥ 35%, and RV S’ ≥9.5 cm/sec). The primary outcome was 30-day mortality.AbstractSection ResultsA cohort of 702 septic patients was analyzed. Patients with biventricular dysfunction (n = 113) and isolated RV dysfunction (n = 117) exhibited mortality rates of 34.5% and 36.7%, respectively. In comparison, lower mortality rates were observed in patients with isolated LV dysfunction (n = 72), hyperdynamic LV function (n = 86), and normal cardiac function (n = 314), with rates of 15.3%, 15.1% and 9.2%, respectively. Cox regression analysis confirmed that biventricular dysfunction (hazard ratio [HR] 2.312, 95% confidence interval [CI] 1.291–4.139, p = 0.005) and isolated RV dysfunction (HR 2.655, 95% CI 1.455–4.843, p = 0.001) were independently associated with 30-day mortality. Neither isolated LV dysfunction (HR 1.171, 95% CI 0.463–2.960, p = 0.739) nor hyperdynamic LV function (HR 2.153, 95% CI 0.971–4.773, p = 0.059) were independently associated with 30-day mortality.AbstractSection ConclusionsSeptic patients with biventricular dysfunction or isolated RV dysfunction had significantly higher 30-day mortality rates compared to those with normal cardiac function. Notably, hyperdynamic LV function also showed a trend toward higher 30-day mortality than normal cardiac function, although this association did not reach statistical significance. In contrast, isolated LV dysfunction was not associated with 30-day mortality. 
651 4 |a United States--US 
653 |a Doppler effect 
653 |a Patients 
653 |a Sepsis 
653 |a Neutrophils 
653 |a Medical prognosis 
653 |a Heart 
653 |a Mortality 
653 |a Septic shock 
653 |a Cardiomyopathy 
653 |a Hemodynamics 
653 |a Ventricle 
653 |a Cardiac function 
653 |a Critical care 
700 1 |a Gao, Beijun 
700 1 |a Liu, Ye 
700 1 |a Zhang, Qing 
700 1 |a Wang, Xiaoting 
773 0 |t BMC Anesthesiology  |g vol. 25 (2025), p. 1-11 
786 0 |d ProQuest  |t Health & Medical Collection 
856 4 1 |3 Citation/Abstract  |u https://www.proquest.com/docview/3236998811/abstract/embedded/7BTGNMKEMPT1V9Z2?source=fedsrch 
856 4 0 |3 Full Text  |u https://www.proquest.com/docview/3236998811/fulltext/embedded/7BTGNMKEMPT1V9Z2?source=fedsrch 
856 4 0 |3 Full Text - PDF  |u https://www.proquest.com/docview/3236998811/fulltextPDF/embedded/7BTGNMKEMPT1V9Z2?source=fedsrch