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Right ventricle in sepsis: clinical and research priority
  1. Siddharth P Dugar1,2,
  2. Saraschandra Vallabhajosyula3,4,5
  1. 1 Department of Critical Care Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, Ohio, United States
  2. 2 Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio, United States
  3. 3 Section of Interventional Cardiology, Division of Cardiovascular Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, United States
  4. 4 Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, United States
  5. 5 Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota, United States
  1. Correspondence to Dr Saraschandra Vallabhajosyula, Section of Interventional Cardiology, Division of Cardiovascular Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA; svalla4{at}emory.edu

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Sepsis remains a significant health challenge affecting more than 750 000 patients each year in the USA. In recent times, there has been an increasing recognition and understanding of cardiac involvement in sepsis.1 2 Septic cardiomyopathy is described as acute-onset reversible cardiac dysfunction developing in the setting of sepsis, which may present as systolic and or diastolic dysfunction of one or both ventricles in the absence of an ischaemic event.2 Prior studies have largely focused on left ventricular involvement; however, in recent times, there has been greater recognition of right ventricular (RV) involvement in sepsis.1 In this issue of Heart, Kim and colleagues present a timely study looking at the impact of RV dysfunction on the clinical outcomes of septic shock.3 This single-centre retrospective study performed transthoracic echocardiography (TTE) <72 hours of admission in patients with septic shock. They excluded patients with congenital heart disease, symptomatic heart failure, moderate or greater valvular heart disease, and prior TTE abnormalities. The primary outcome of 28-day mortality was higher in patients with septic cardiomyopathy (35.9% vs 26.8%, p<0.01), particularly in patients with isolated RV dysfunction (5.2% vs 2.2%, p=0.04) and combined left ventricular systolic and RV dysfunction (8.6% vs 4.6%, p=0.03). Multivariate analysis showed RV dysfunction to be independently associated with higher 28-day morality. We commend the authors for their work addressing important …

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Footnotes

  • Twitter @siddharth_dugar, @SarasVallabhMD

  • Contributors Both study authors were involved in the literature review, writing and editing of the draft of the manuscript and provided the final approval.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, conduct, reporting or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.

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