SPC365

The Hidden Threat of Septic Cardiomyopathy: Unmasking Its Impact on ICU Survival

Session: SESSÃO DE POSTERS 33 - DOENÇAS CARDIOVASCULARES - MINOCA E SÍNDROME DE TAKOTSUBO
Speaker: Sofia Esteves

Congress: CPC 2025
Topic: E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme: 14. Acute Cardiac Care
Subtheme: 14.3 Acute Cardiac Care – CCU, Intensive, and Critical Cardiovascular Care
Session Type: Cartazes
FP Number: ---
Authors: Sofia Esteves; Miguel Azaredo Raposo; Ana Rita M. Figueiredo; Catarina Santos Gregório; Ana Abrantes; Marta Vilela; Diogo Rosa Ferreira; Inês Caldeira de Araújo; João Fernandes Pedro; João Mendes Cravo; Fausto J. Pinto; Doroteia Silva

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Introduction: </strong></span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">Septic cardiomyopathy (SC) is characterized by myocardial dysfunction in patients with sepsis, leading to severe hemodynamic instability. Many uncertainties still remain regarding mechanisms, characteristics, treatment and even prognosis of this condition.&nbsp;</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Purpose: </strong></span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">To compare intensive care unit (ICU) mortality between patients with septic cardiomyopathy (SC) and patients without septic cardiomyopathy (controls). Also, to compare clinical, laboratory and echocardiographic characteristics of SC patients who survived (SCs) and those who did not (SCd).&nbsp;</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Methods: </strong></span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">Retrospective, observational, single-center study of patients admitted in ICU during 2022 and 2023 due to sepsis, with or without a diagnosis of SC. Kaplan-Meier survival analysis was performed. </span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Results: </strong></span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">We included 58 SC patients (mean age 66.7 &plusmn; 15.4 years, 62.1% male) and 248 controls (mean age 65 &plusmn; 16.2 years, 61.3% male). Regarding SC patients, in-hospital mortality was 56.9%, with 55.2% of deaths occurring during ICU stay. The mean time to death was 3.5 days for SC patients and 5 days for non-SC patients. ICU mortality was significantly higher in SC patients than controls (p = 0.01, log rank test)- Figure 1.&nbsp;</span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">Regarding SC patients, length of ICU stay was similar between survivors and non-survivors. However, infection source control was significantly better in survivors (SCs: 80% vs. SCd: 46%, p = 0.01). Inotrope and vasopressor doses were higher in non-survivors (peak noradrenaline dose SCd: 220 mcg/min vs. SCs: 60 mcg/min, p &lt; 0.001). Organ dysfunction was similar between groups, except for KDIGO III acute renal failure, which was higher in non-survivors, though not statistically significant (SCd: 83.3% vs. SCs: 70%, p = 0.052).&nbsp;</span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">Non-survivors had higher troponin (SCs: 48 ng/L vs. SCd: 103 ng/L, p = 0.015) and peak lactate levels (SCd: 95 mg/dL vs. SCs: 45 mg/dL, p = 0.05), at ICU admission. Left ventricular ejection fraction recovery at ICU discharge was significantly higher in survivors (SCd: 10.3% vs. SCs: 93.3%, p &lt; 0.001).&nbsp;</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Conclusions: </strong></span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">SC was linked to higher ICU mortality. Infection source control was better in SC survivors. Non-survivors had higher doses of inotropes/vasopressors and higher troponin and lactate levels, at ICU admission. Early recognition and management are crucial for SC prognosis improvement.</span></span></span></p>