• Filippo Sanfilippo, Stephen Huang, Antonio Messina, Federico Franchi, Francesco Oliveri, Antoine Vieillard-Baron, Maurizio Cecconi, and Marinella Astuto.
• Department of Anesthesia and Intensive Care, Policlinico - San Marco University Hospital, Catania, Italy. Electronic address: filipposanfi@yahoo.it.
• J Crit Care. 2021 Apr 1; 62: 256-264.

PurposeSeptic induced cardiomyopathy has a wide spectrum of presentation, being associated with systolic and/or diastolic dysfunction. There is currently no evidence of association between left ventricular (LV) systolic dysfunction and mortality in septic patients.MethodsWe conducted a systematic review and meta-analysis to investigate the association between systolic wave (s') obtained with Tissue Doppler Imaging (TDI) and mortality in septic patients. Secondary outcome was the association of LV ejection fraction with mortality.ResultsIn the primary analysis we included a total of 13 studies (1197 patients, mortality 39.9%); overall s' wave was not significantly different between survivors and non-survivors (Standardized Mean Difference 0.20, 95%Confidence-Interval - 0.18, 0.59). This result was confirmed also in sub-groups analyses according to regional criteria of TDI sampling. A post-hoc analysis including only septic shock patients confirmed that s' wave was not associated with mortality. Several sensitivity analyses confirmed these results. We found no evidence of publication bias. The secondary analysis (11 studies, 1081 patients, mortality 36.7%) showed that LV ejection fraction was not associated with mortality (Mean Difference 0.98, 95% Confidence-Interval - 1.79,3.75).ConclusionsThere is no association between mortality and LV systolic function as evaluated by TDI s' wave in septic patients.Copyright © 2020 Elsevier Inc. All rights reserved.

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