Long-term outcomes of abnormal global longitudinal left ventricular strain during sepsis: A retrospective cohort study.
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Huespe Ivan, Sosa Fernando A, Jena Anek, Pareek Aayushi, Saleem Faiz, Bateh Said, Andrade Lucia Bertorello, Oribe Barbara Tort, Daldoss Federico, Soto Jose Soto, Delgado Jose, Raavi Lekhya, Jonna Sadhana, Garcia Belen, Ivulich Daniel, Mendez Jorge, Monzon Veronica, Prado Eduardo, Isha Shahin, Reddy Swetha, Olanipekun Titilope, Harrison Michael, Gnanapandithan Karthik, Thompson Kristine M, Graham Charles G, Cowdell Jed C, Baptista Aleksandra Murawska, Kelly Nick, Helgesson Scott A, Patel Parag, Jentzer Jacob C, Smith Jeff, Hanson Abby, Caples Sean M, Khan Syed, Jain Nitesh K, Cartin-Ceba Rodrigo, Venegas Carla P, Shapiro Anna B, Bhattacharyya Anirban, Chaudhary Sanjay, Kiley Sean P, Quinones Quintin J, Patel Neal M, Guru Pramod K, Franco Pablo Moreno, Sanghavi Devang K
Аннотация
METHODS: This multicenter retrospective open cohort study included 439 patients hospitalized with sepsis or septic shock between 2018 and 2022. LV systolic function was assessed using LV GLS and Left Ventricular Ejection Fraction (LVEF) within seven days of admission. Patients were followed until July 2024. Restricted cubic spline Cox regression models examined non-linear associations between LV GLS, LVEF, and MACE. Additionally, Cox regression models adjusted for demographics, comorbidities, laboratory values, and sepsis severity markers evaluated whether LV systolic dysfunction, defined as high LV GLS (> -16) or low LVEF, were predictors of MACE.
RESULTS: During the study period, 439 septic patients were included, totaling 595 patient-years of follow-up. Among them, 254 experienced MACE. LV GLS exhibited a non-linear association with MACE, with values between -23 and - 16 associated with the lowest risk. High LV GLS was independently associated with MACE (unadjusted HR: 1.4 [95% CI: 1.07, 1.8; p = 0.01]; adjusted HR 1.38 [95% CI: 1.01, 1.9; p = 0.04]). In contrast, low LVEF was not associated with MACE (unadjusted HR 1.2 [95% CI: 0.9, 1.5; p = 0.2]; adjusted HR 1.03 [95% CI: 0.73, 1.45; p = 0.8]).
CONCLUSIONS: LV GLS was an independent predictor of MACE in septic patients, whereas LVEF did not show a significant association. These findings suggest that LV GLS may be a valuable biomarker for long-term cardiovascular risk stratification in this population.