Background: Cardiac dysfunction, commonly observed in sepsis patients, is associated with higher mortality rates. The left ventricular stroke work index (LVSWI), an integrated parameter reflecting overall left ventricular function, may serve as a reliable and practical prognosticator for sepsis.
Methods: Using the Medical Information Mart for Intensive Care (MIMIC III) database, we carried out a retrospective observational study that included adult patients who met the Sepsis-3 criteria. Kaplan-Meier survival curves and Cox proportional hazard models were applied to examine the association between LVSWI and 30-day all-cause mortality. Restricted cubic spline plots were used to assess the non-linear relationship between LVSWI and mortality, and subgroup analyses were conducted across various variables.
Results: A total of 1,348 septic patients were included, with 300 (22.3%) fatalities. In multivariate Cox proportional hazard models, a significant negative relationship between LVSWI and mortality was observed, with a 31% reduction in mortality risk associated with an increase of one standard deviation in LVSWI (hazard ratio [HR]: 0.69, 95% confidence interval [CI]: 0.51-0.93, p = 0.016), following adjustment for confounders. Restricted cubic spline plots unveiled a non-linear, L-shaped relationship between LVSWI and mortality. Furthermore, a two-piecewise regression model identified the critical inflection point at 27.83 g·m/m², with HR (95% CI) values of 0.93 (0.90-0.96; p < 0.001) on the left and 1.00 (0.99-1.01; p = 0.913) on the right.
Conclusions: The LVSWI exhibited an L-shaped relationship with 30-day mortality in patients with sepsis, underscoring the potential of LVSWI as a dependable prognostic indicator for sepsis. Further studies are needed to confirm these findings and to investigate whether early interventions to optimize LVSWI could improve outcomes in this patient population.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1186/s12879-025-10723-x | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Macitentan for Heart Failure With Preserved or Mildly Reduced Ejection Fraction and Pulmonary Vascular Disease: Results of the SERENADE Randomized Clinical Trial and Open-Label Extension Study.
Circ Heart Fail
March 2025
Department of Medicine, University of Maryland School of Medicine, Baltimore (M.T.G.).
Background: Despite favorable hemodynamic and neurohormonal effects, endothelin receptor antagonists have not improved outcomes in patients with heart failure (HF), possibly because they cause fluid retention.
Methods: In this randomized, double-blind, multicenter trial (SERENADE [Macitentan in Heart Failure With Preserved Ejection Fraction and Pulmonary Vascular Disease]), we evaluated the effects of an endothelin receptor antagonist, macitentan, in patients with HF, left ventricular ejection fraction ≥40%, and pulmonary vascular disease. After a 4-week placebo run-in (to ensure clinical stability), followed by a 5-week single-blind macitentan run-in, patients who did not exhibit fluid retention were randomized to macitentan or placebo.
LAMP2-FLOT2 interaction enhances autophagosome-lysosome fusion to protect the septic heart in response to ILC2.
Autophagy
March 2025
Department of Critical Care Medicine and Emergency, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Cardiac dysfunction is a serious complication of sepsis-induced multiorgan failure in intensive care units and is characterized by an uncontrolled immune response to overwhelming infection. Type 2 innate lymphoid cells (ILC2s), as a part of the innate immune system, play a crucial role in the inflammatory process of heterogeneous cardiac disorders. However, the role of ILC2 in regulating sepsis-induced cardiac dysfunction and its underlying mechanism remain unknown.
View Article and Find Full Text PDFIntraprocedural activated clotting time and heparin dosage in pulsed field ablation of paroxysmal atrial fibrillation.
Front Cardiovasc Med
February 2025
Department of Cardiology, Institute of Cardiovascular Diseases, First Affiliated Hospital of Dalian Medical University, Dalian, China.
Aims: Whether the intraprocedural anticoagulation regimen and activated clotting time (ACT) in pulsed field ablation (PFA) for atrial fibrillation (AF) are the same as those for radiofrequency catheter ablation (RFCA) is currently unknown.
Methods And Results: Our retrospective study included 51 paroxysmal AF patients who underwent PFA (PFA group) and were matched with paroxysmal AF patients who underwent RFCA. Nearest-neighbor propensity score matching was performed at a 1:1 ratio (no tolerance to anticoagulant regimens and a tolerance of 0.
Myocardial T1 Mapping, Left Ventricular Parameters, and Cardiac Biomarkers in Wild-Type Transthyretin Amyloid Cardiomyopathy Before and After Tafamidis Treatment.
Circ Rep
March 2025
Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences Hiroshima Japan.
Background: To further elucidate the clinical implications of myocardial T1 mapping with cardiac magnetic resonance (CMR) in transthyretin amyloid cardiomyopathy (ATTR-CM), we investigated the relationships of native myocardial T1 value (T1) and extracellular volume fraction (ECV) with left ventricular (LV) parameters and cardiac biomarkers in ATTR-CM patients before and after tafamidis treatment.
Methods And Results: We studied wild-type ATTR-CM patients who underwent baseline CMR with LV cine and T1 mapping techniques. T1 and ECV were derived from averaged values of base-to-apex LV myocardium.
Background: In heart failure (HF) patients with a higher left ventricular ejection fraction (LVEF), the B-type natriuretic peptide (BNP) level is yet to be fully assessed. Accordingly, we hypothesized that the BNP level should be higher in patients with a higher LVEF range based on the previous finding that such patients were associated with a worse prognosis.
Methods And Results: In our multicenter, prospective, observational cohort for the composite endpoint of all-cause death and readmission due to HF, including patients with LVEF >40% at hospital discharge, we obtained LVEF, E/e', and BNP levels in 231 patients.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!