(161) Long-Term Outcomes of Abnormal Global Longitudinal Left Ventricular Strain During Sepsis

Introduction: Patients admitted with sepsis are vulnerable to developing Septic Cardiomyopathy (SCM), which heightens the short-term mortality risk. Literature suggests a link between left ventricular global longitudinal strain (LV GLS) and adverse long-term outcomes in sepsis survivors. This study investigates whether individuals with both sepsis and SCM experience worse long-term outcomes compared to those without SCM.

Methods: We conducted a retrospective study of patients with SCM from Mayo Clinic Florida, USA, and Hospital Alemán, Argentina, from August 2018 to September 2022. Data on demographics, comorbidities, echo parameters (LV strain), and Major Adverse Cardiovascular Events (MACE) including death, myocardial infarction, or stroke within 3 years after hospital discharge were collected. The primary outcome was the relation between LV GLS and MACE. Due to the anticipated non-linear relationship, we used a Cox regression model with Restricted Cubic Splines. After the non-linear analysis, we evaluated the relationship between normal LV GLS and MACE adjusting by propensity scores through Inverse Probability Weighting (adjusting for confounders such as diabetes, hypertension, BMI, history of stroke or myocardial infarction, chronic kidney disease, age, and sex).

Results: The mean age of our study population was 63 years (SD 16), with 40.5% females. Among them, 41.4% died, 7.32% had a stroke, and 10.6% experienced myocardial infarction within 3 years of admission (MACE events). Cox regression analysis with restricted cubic splines showed that the hazard ratio (HR) of MACE was significantly higher than 1 with LV GLS values lower than -23 and higher than -16. Thus, we categorized the range lower than -23 and higher than -16 as "non-normal strain" and evaluated it as an independent risk factor for MACE events. After applying inverse probability weighting with propensity score adjustment, the hazard ratio was 0.7 (95% CI 0.5, 0.9).

Conclusions: When SCM affects LV GLS, it indicates a negative impact on long-term cardiovascular health after discharge, with this condition being an independent risk factor for MACE.