Prevalence and prognosis of hyperdynamic left ventricular systolic function in septic patients: a systematic review and meta-analysis

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Abstract

Purpose

The prevalence of hyperdynamic left ventricular (LV) systolic function in septic patients and its impact on mortality remain controversial. In this systematic review and meta-analysis, we investigated the prevalence and association of hyperdynamic LV systolic function with mortality in patients with sepsis.

Methods

We searched MEDLINE, Cochrane Central Register of Controlled Trials, and Embase. Primary outcomes were the prevalence of hyperdynamic LV systolic function in adult septic patients and the associated short-term mortality as compared to normal LV systolic function. Hyperdynamic LV systolic function was defined using LV ejection fraction (LVEF) of 70% as cutoff. Secondary outcomes were heart rate, LV end-diastolic diameter (LVEDD), and E/e’ ratio.

Results

Four studies were included, and the pooled prevalence of hyperdynamic LV systolic function was 18.2% ([95% confidence interval (CI) 12.5, 25.8]; I ² = 7.0%, P < 0.0001). Hyperdynamic LV systolic function was associated with higher mortality: odds ratio of 2.37 [95%CI 1.47, 3.80]; I ² = 79%, P < 0.01. No difference was found in E/e’ ( P = 0.43) between normal and hyperdynamic LV systolic function, while higher values of heart rate (mean difference: 6.14 beats/min [95%CI 3.59, 8.69]; I ² = 51%, P < 0.0001) and LVEDD (mean difference: − 0.21 cm [95%CI − 0.33, − 0.09]; I ² = 73%, P < 0.001) were detected in patients with hyperdynamic LV systolic function.

Conclusion

The prevalence of hyperdynamic LV systolic function is not negligible in septic patients. Such a finding is associated with significantly higher short-term mortality as compared to normal LV systolic function.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13613-024-01255-9.

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Author and article information

Contributors

Siddharth Dugar:

ORCID: http://orcid.org/0000-0002-3243-1417

dugars@ccf.org

Journal

Journal ID (nlm-ta): Ann Intensive Care

Journal ID (iso-abbrev): Ann Intensive Care

Title: Annals of Intensive Care

Publisher: Springer International Publishing (Cham )

ISSN (Electronic): 2110-5820

Publication date (Electronic): 3 February 2024

Publication date PMC-release: 3 February 2024

Publication date Collection: 2024

Volume: 14

Electronic Location Identifier: 22

Affiliations

[1 ]Division of Critical Care Medicine, Department of Medicine, The Queen’s Medical Center, ( https://ror.org/016gbn942) Honolulu, HI USA

[2 ]Department of Anaesthesia and Intensive Care, A.O.U. Policlinico-San Marco, Site “Policlinico G. Rodolico”, Via S. Sofia N 78, 95123 Catania, Italy

[3 ]Department of Internal Medicine, Mount Sinai Beth Israel, ( https://ror.org/01742jq13) New York, NY USA

[4 ]Department of Cardiovascular Medicine, Mayo Clinic, ( https://ror.org/02qp3tb03) Rochester, MN USA

[5 ]Department of Critical Care Medicine, Respiratory Institute, Cleveland Clinic, ( https://ror.org/03xjacd83) 9500 Euclid Ave, Cleveland, OH 44195 USA

[6 ]Cleveland Clinic Lerner College of Medicine, ( https://ror.org/02x4b0932) Cleveland, OH USA

Author information

Siddharth Dugar http://orcid.org/0000-0002-3243-1417

Article

Publisher ID: 1255

DOI: 10.1186/s13613-024-01255-9

PMC ID: 10838258

PubMed ID: 38308701

SO-VID: dde6191b-9a67-4789-8056-e4ce6ba52f98

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

History

Date received : 13 July 2023

Date accepted : 21 January 2024

Custom metadata

issue-copyright-statement © La Société de Réanimation de Langue Francaise = The French Society of Intensive Care (SRLF) 2024

ScienceOpen disciplines: Emergency medicine & Trauma

Keywords: sepsis,septic shock,hyperkinetic,hyperdynamic,mortality,left ventricular ejection fraction

Data availability: