New-Onset Heart Failure and Mortality in Hospital Survivors of Sepsis-Related Left Ventricular Dysfunction

Saraschandra Vallabhajosyula, Jacob C. Jentzer, Jeffrey B. Geske, Mukesh Kumar, Ankit Sakhuja, Akhil Singhal, Joseph T. Poterucha, Kianoush Kashani, Joseph G. Murphy, Ognjen Gajic, Rahul Kashyap

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

BACKGROUND:: The association between new-onset left ventricular (LV) dysfunction during sepsis with long-term heart failure outcomes is lesser understood. METHODS:: Retrospective cohort study of all adult patients with severe sepsis and septic shock between 2007 and 2014 that underwent echocardiography within 72?hours admitted to the intensive care unit. Patients with prior heart failure, LV dysfunction, and structural heart disease were excluded. LV systolic dysfunction was defined as LV ejection fraction <50% and LV diastolic dysfunction as ≥grade II. Primary composite outcome included new hospitalization for acute decompensated heart failure and all-cause mortality at two-year follow-up. Secondary outcomes included persistent LV dysfunction, and hospital mortality and length of stay. RESULTS:: During this 8-year period, 434 patients with 206 (48%) patients having LV dysfunction were included. The two groups had similar baseline characteristics, but those with LV dysfunction had worse function as demonstrated by worse LV ejection fraction, cardiac index, and LV diastolic dysfunction. In the 331 hospital survivors, new-onset acute decompensated heart failure hospitalization did not differ between the two cohorts (15% vs. 11%). The primary composite outcome was comparable at two-year follow-up between the groups with and without LV dysfunction (p?=?0.24). Persistent LV dysfunction was noted in 28% hospital survivors on follow-up echocardiography. Other secondary outcomes were similar between the two groups. CONCLUSIONS:: In patients with severe sepsis and septic shock, the presence of new-onset LV dysfunction did not increase the risk of long-term adverse heart failure outcomes.

Original languageEnglish (US)
JournalShock
DOIs
StateAccepted/In press - Jul 19 2017

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Left Ventricular Dysfunction
Hospital Mortality
Survivors
Sepsis
Heart Failure
Septic Shock
Stroke Volume
Echocardiography
Hospitalization
Intensive Care Units
Heart Diseases
Length of Stay
Cohort Studies
Retrospective Studies

ASJC Scopus subject areas

  • Emergency Medicine
  • Critical Care and Intensive Care Medicine

Cite this

Vallabhajosyula, S., Jentzer, J. C., Geske, J. B., Kumar, M., Sakhuja, A., Singhal, A., ... Kashyap, R. (Accepted/In press). New-Onset Heart Failure and Mortality in Hospital Survivors of Sepsis-Related Left Ventricular Dysfunction. Shock. https://doi.org/10.1097/SHK.0000000000000952

New-Onset Heart Failure and Mortality in Hospital Survivors of Sepsis-Related Left Ventricular Dysfunction. / Vallabhajosyula, Saraschandra; Jentzer, Jacob C.; Geske, Jeffrey B.; Kumar, Mukesh; Sakhuja, Ankit; Singhal, Akhil; Poterucha, Joseph T.; Kashani, Kianoush; Murphy, Joseph G.; Gajic, Ognjen; Kashyap, Rahul.

In: Shock, 19.07.2017.

Research output: Contribution to journalArticle

Vallabhajosyula, S, Jentzer, JC, Geske, JB, Kumar, M, Sakhuja, A, Singhal, A, Poterucha, JT, Kashani, K, Murphy, JG, Gajic, O & Kashyap, R 2017, 'New-Onset Heart Failure and Mortality in Hospital Survivors of Sepsis-Related Left Ventricular Dysfunction', Shock. https://doi.org/10.1097/SHK.0000000000000952
Vallabhajosyula, Saraschandra ; Jentzer, Jacob C. ; Geske, Jeffrey B. ; Kumar, Mukesh ; Sakhuja, Ankit ; Singhal, Akhil ; Poterucha, Joseph T. ; Kashani, Kianoush ; Murphy, Joseph G. ; Gajic, Ognjen ; Kashyap, Rahul. / New-Onset Heart Failure and Mortality in Hospital Survivors of Sepsis-Related Left Ventricular Dysfunction. In: Shock. 2017.
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AU - Geske, Jeffrey B.

AU - Kumar, Mukesh

AU - Sakhuja, Ankit

AU - Singhal, Akhil

AU - Poterucha, Joseph T.

AU - Kashani, Kianoush

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N2 - BACKGROUND:: The association between new-onset left ventricular (LV) dysfunction during sepsis with long-term heart failure outcomes is lesser understood. METHODS:: Retrospective cohort study of all adult patients with severe sepsis and septic shock between 2007 and 2014 that underwent echocardiography within 72?hours admitted to the intensive care unit. Patients with prior heart failure, LV dysfunction, and structural heart disease were excluded. LV systolic dysfunction was defined as LV ejection fraction <50% and LV diastolic dysfunction as ≥grade II. Primary composite outcome included new hospitalization for acute decompensated heart failure and all-cause mortality at two-year follow-up. Secondary outcomes included persistent LV dysfunction, and hospital mortality and length of stay. RESULTS:: During this 8-year period, 434 patients with 206 (48%) patients having LV dysfunction were included. The two groups had similar baseline characteristics, but those with LV dysfunction had worse function as demonstrated by worse LV ejection fraction, cardiac index, and LV diastolic dysfunction. In the 331 hospital survivors, new-onset acute decompensated heart failure hospitalization did not differ between the two cohorts (15% vs. 11%). The primary composite outcome was comparable at two-year follow-up between the groups with and without LV dysfunction (p?=?0.24). Persistent LV dysfunction was noted in 28% hospital survivors on follow-up echocardiography. Other secondary outcomes were similar between the two groups. CONCLUSIONS:: In patients with severe sepsis and septic shock, the presence of new-onset LV dysfunction did not increase the risk of long-term adverse heart failure outcomes.

AB - BACKGROUND:: The association between new-onset left ventricular (LV) dysfunction during sepsis with long-term heart failure outcomes is lesser understood. METHODS:: Retrospective cohort study of all adult patients with severe sepsis and septic shock between 2007 and 2014 that underwent echocardiography within 72?hours admitted to the intensive care unit. Patients with prior heart failure, LV dysfunction, and structural heart disease were excluded. LV systolic dysfunction was defined as LV ejection fraction <50% and LV diastolic dysfunction as ≥grade II. Primary composite outcome included new hospitalization for acute decompensated heart failure and all-cause mortality at two-year follow-up. Secondary outcomes included persistent LV dysfunction, and hospital mortality and length of stay. RESULTS:: During this 8-year period, 434 patients with 206 (48%) patients having LV dysfunction were included. The two groups had similar baseline characteristics, but those with LV dysfunction had worse function as demonstrated by worse LV ejection fraction, cardiac index, and LV diastolic dysfunction. In the 331 hospital survivors, new-onset acute decompensated heart failure hospitalization did not differ between the two cohorts (15% vs. 11%). The primary composite outcome was comparable at two-year follow-up between the groups with and without LV dysfunction (p?=?0.24). Persistent LV dysfunction was noted in 28% hospital survivors on follow-up echocardiography. Other secondary outcomes were similar between the two groups. CONCLUSIONS:: In patients with severe sepsis and septic shock, the presence of new-onset LV dysfunction did not increase the risk of long-term adverse heart failure outcomes.

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