Sanderson Thomas, Samuels Theophilus
Surrey and Sussex Healthcare NHS Trust, East Surrey Hospital, Redhill, Surrey, RH15RH, UK.
Sci Rep. 2025 May 13;15(1):16606. doi: 10.1038/s41598-025-94909-y.
The understanding of sepsis-related changes in myocardial function is evolving. This single-centre prospective observational cohort pilot study evaluated myoCardial work and Right ventricle Strain In Sepsis (CRiSIS) with 30-day mortality in critical care patients. Measurements were recorded for 32 patients on days 1 and 3 of admission: 22 (69%) survivors and 10 (31%) non-survivors at 30 days. Survivors demonstrated a higher global work efficiency (GWE; 94%, IQR 91-96%) compared to non-survivors (88.5%, IQR 85-92%; p = 0.02, BF = 1.44) on day 3. No significant differences in changes between day 1 and day 3 were observed in MW or RV FWS. Bayesian analysis supported a possible difference in global work index (GWI) and global constructive work (GCW) between survivors and non-survivors on day 1 and for global work index (GWI) on day 3. GWI, GCW, and GWE strongly correlated with left ventricle ejection fraction (LVEF) and global longitudinal strain (GLS), while the relationship with global wasted work (GWW) was weaker. To the best of our knowledge, this is the first study to investigate the role of MW in critically ill patients presenting with sepsis and suggests that it may be a valuable prognostic tool in this patient population.
对脓毒症相关心肌功能变化的认识正在不断发展。这项单中心前瞻性观察性队列试点研究评估了脓毒症患者的心肌做功和右心室应变（CRiSIS）与30天死亡率之间的关系。在入院第1天和第3天对32例患者进行了测量：30天时22例（69%）存活，10例（31%）未存活。在第3天，存活者的整体工作效率（GWE；94%，IQR 91 - 96%）高于未存活者（88.5%，IQR 85 - 92%；p = 0.02，BF = 1.44）。在第1天和第3天之间，心肌做功（MW）或右心室功能储备（RV FWS）的变化没有显著差异。贝叶斯分析支持在第1天存活者和未存活者之间以及第3天的整体工作指数（GWI）可能存在差异。GWI、整体建设性工作（GCW）和GWE与左心室射血分数（LVEF）和整体纵向应变（GLS）密切相关，而与整体无用功（GWW）的关系较弱。据我们所知，这是第一项研究MW在脓毒症危重症患者中的作用的研究，并表明它可能是该患者群体中有价值的预后工具。
