21 Characterisation of cardiovascular function in intensive care unit survivors of sepsis (CONDUCT-ICU): early pilot phase results

Background Sepsis is one of the leading causes of Intensive Care Unit (ICU) and hospital admission in the UK. It is now increasingly recognised that admission with sepsis is associated with a long-term risk of adverse cardiovascular events that is comparable to other major risk factors such as hypertension or dyslipidaemia. Many survivors of critical illness are burdened with significant functional impairments following admission. The extent to which chronic cardiovascular dysfunction may play a role in these functional impairments is unclear. Here we report early results from the first few patients participating in CONDUCT-ICU, an observational cohort study examining the role of cardiac dysfunction in functional impairments following admission to intensive care. Methods CONDUCT-ICU is a pilot, prospective observational cohort study combining cardiac magnetic resonance (CMR) imaging, biomarkers and functional outcome measures. We aim to explore the feasibility of CMR imaging in this population, the prevalence of right ventricular (RV) and left ventricular (LV) dysfunction, mechanisms of long-term cardiac injury and dysfunction following critical illness and the relationship between CMR imaging findings, biomarkers and functional outcomes. Patients admitted to ICU with sepsis without previously known cardiovascular disease were prospectively recruited at the point of ICU discharge and subsequently followed up 6–10 weeks following discharge from hospital. CMR imaging was undertaken at follow-up in addition to the collection of patient-reported outcome measures and inflammatory and cardiac biomarkers. We explored the prevalence of left and right ventricular systolic dysfunction and compared to local control populations. Results 27 patients were recruited to the study, of which 15 were able to attend follow-up and complete CMR imaging. 8 participants were male and 7 participants female. Median left ventricular ejection fraction (LVEF) was 56% (IQR 50–59). Median right ventricular ejection fraction was 52.5% (IQR 44–57). 6 patients (40%) had persisting evidence of left or right ventricular systolic dysfunction despite resolution of their index illness. Conclusion In this small pilot study of ICU survivors without previously diagnosed cardiac dysfunction, sepsis was associated with persisting LV or RV dysfunction in over one third of patients.