Sepsis Induced Cardiomyopathy associated with significantly higher short-term mortality

Recent advances in diagnostic techniques have increased the sensitivity of detection of myocardial abnormalities but have posed challenges in linking those abnormalities to therapeutic strategies and relevant clinical outcomes. Sophisticated methodologies have elucidated various pathophysiological mechanisms in Sepsis Induced Cardiomyopathy but the extent to which these are adaptive responses is yet to be known.

The prevalence and its impact on mortality of sepsis-induced cardiomyopathy (SICM) remain controversial. A recent systematic review and meta-analysis, in Journal of Intensive Care Medicine investigated the prevalence and prognosis of SICM.

Dr Daisuke Hasegawa, MD, PhD and team reported that the meta-analysis found the prevalence of SICM was 20% higher in patients with sepsis, and the occurrence of SICM was associated with significantly higher short-term mortality.

Researchers searched MEDLINE, Cochrane Central Register of Controlled Trials, and Embase. Titles and abstracts were evaluated based on the following criteria: published in English, randomized controlled trials, cohort studies, or cross-sectional studies,  ≥ 18 years with sepsis, reporting the prevalence and/or comparison of short-term mortality between those with and without SICM, defined as the new-onset reduction in left ventricular ejection fraction (LVEF) within 72 h on admission or from the diagnosis of sepsis. The random-effect model was used for all analyses.

The key findings of the study are

• Sixteen studies reported the prevalence of SICM and the pooled prevalence of SICM was 20% (95% confidence interval [CI], 16-25%; I2  =  89.9%, P < 0.01).

• Eleven studies reported short-term mortality and SICM was associated with significantly higher short-term mortality (The pooled odds ratio: 2.30, 95% CI, 1.43-3.69; I2  =  0%, P  =  0.001).

The results of this study highlight the significant proportion of patients with sepsis who develop cardiomyopathy and the increased risk of mortality associated with this condition. Further research is needed to identify patients with an increased risk of sepsis-induced cardiomyopathy as well as optimal monitoring and management of these patients.

Dr Daisuke Hasegawa and team concluded that the prevalence of SICM was 20% in patients with sepsis, and the occurrence of SICM was associated with significantly higher short-term mortality.

Reference: Hasegawa D, Ishisaka Y, Maeda T, et al. Prevalence and Prognosis of Sepsis-Induced Cardiomyopathy: A Systematic Review and Meta-Analysis. Journal of Intensive Care Medicine. 2023;0(0). doi:10.1177/08850666231180526.