• Philippe Vignon, Cyril Charron, Annick Legras, Frédérique Musset, Michel Slama, Gwenaël Prat, Stein Silva, David Vandroux, Grégoire Müller, Bruno Levy, Florence Boissier, Bruno Evrard, Marine Goudelin, Stéfan Mankikian, Mai-Anh Nay, Julien Jabot, Béatrice Riu, Pierre Bailly, Julien Maizel, Julie Léger, Antoine Vieillard-Baron, and CRICS-TRIGGERSEP Network.
• Medical-Surgical ICU, Dupuytren University Hospital, Réanimation Polyvalente, CHU Dupuytren, Limoges, France. philippe.vignon@unilim.fr.
• Intensive Care Med. 2025 Jan 1; 51 (1): 9410594-105.

PurposePrognostic impact of left ventricular diastolic dysfunction (LVDD) in septic shock patients has not been determined using current diagnostic guidelines. We assessed the relation between LVDD during the first 3 days following intensive care unit (ICU) admission for septic shock and Day-28 mortality.MethodsThis prospective, multicenter, observational study enrolled 402 patients (age: 63 ± 13 year; 59% male; SAPS II: 59 ± 20; SOFA: 9.4 ± 3.6; mechanical ventilation: 74%) with septic shock (Sepsis-3 definition). Patients were echocardiographically assessed within 12 h after admission (Day 1), on Day 2, Day 3, at ICU and at hospital discharge (or Day 28 whichever occurred first), using 2016 American-European guidelines.ResultsLVDD was present at least once between Day 1 and 3 in 304 patients (76%), and in 56% and 44% of patients at ICU discharge and on Day 28 (or hospital discharge), respectively (43% of patients with follow-up). Seventy-eight of 172 patients (45%) exhibited similar LV diastolic properties throughout the study period while 58 patients (34%) improved their LVDD at follow-up (lower grade: n = 9, regression: n = 49). Day-28 mortality was not statistically different between patients with and without LVDD (80/304 [26%] vs. 25/88 [28%]; OR: 0.900 [0.530-1.527]; p = 0.696). Similar results were obtained when adjusting the multivariate model on SAPSII or SOFA score on admission, together with fluid balance during the first three days of ICU stay (OR: 0.838 [0.471-1.491]: p = 0.547 and OR: 0.887 [0.513-1.534]: p = 0.668, respectively).ConclusionLVDD was highly prevalent in patients with septic shock but not associated with mortality. It appeared improving in one-third of survivors.Trial RegistrationPRODIASYS study registered on ClinicalTrials (September 27, 2016, number NCT02918214).© 2025. Springer-Verlag GmbH Germany, part of Springer Nature.

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