{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T04:54:42Z","timestamp":1787979282601,"version":"build-2784847793"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T00:00:00Z","timestamp":1766188800000},"content-version":"vor","delay-in-days":1538,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2021,10,4]],"date-time":"2021-10-04T00:00:00Z","timestamp":1633305600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Emelle Foundation"},{"name":"Foundation of Ollie and Elof Ericsson"},{"DOI":"10.13039\/100007212","name":"V\u00e4stra G\u00f6talandsregionen","doi-asserted-by":"publisher","award":["ALFGBG-775041"],"award-info":[{"award-number":["ALFGBG-775041"]}],"id":[{"id":"10.13039\/100007212","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003793","name":"Hj\u00e4rt-Lungfonden","doi-asserted-by":"publisher","award":["20170631"],"award-info":[{"award-number":["20170631"]}],"id":[{"id":"10.13039\/501100003793","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007212","name":"V\u00e4stra G\u00f6talandsregionen","doi-asserted-by":"publisher","award":["ALFGBG\u2010775041"],"award-info":[{"award-number":["ALFGBG\u2010775041"]}],"id":[{"id":"10.13039\/100007212","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003793","name":"Hj\u00e4rt-Lungfonden","doi-asserted-by":"publisher","award":["20170631"],"award-info":[{"award-number":["20170631"]}],"id":[{"id":"10.13039\/501100003793","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Left ventricular (LV) dysfunction can be triggered by non-cardiac disease, such as sepsis, hypoxia, major haemorrhage, or severe stress (Takotsubo syndrome), but its clinical importance is not established. In this study, we evaluate the incidence and impact on mortality of LV dysfunction associated with critical illness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>In this single-centre, observational study, consecutive patients underwent an echocardiographic examination within 24 h of intensive care unit (ICU) admission. LV systolic dysfunction was defined as an ejection fraction (EF) &amp;lt; 50% and\/or regional wall motion abnormalities (RWMA). A cardiologist assessed patients with LV dysfunction for the presence of an acute or chronic cardiac disease, and coronary angiography was performed in high-risk patients. Of the 411 patients included, 100 patients (24%) had LV dysfunction and in 52 (13%) of these patients, LV dysfunction was not attributed to a cardiac disease. Patients with LV dysfunction and non-cardiac disease had higher mortality risk score (Simplified Acute Physiologic Score 3 score), heart rate, noradrenaline doses, and lactate levels as well as decreased EF, stroke volume, and cardiac output compared with patients with normal LV function. Diagnoses most commonly associated with LV dysfunction and non-cardiac disease were sepsis, respiratory insufficiency, major haemorrhage, and neurological disorders. RWMA (n = 40) with or without low EF was more common than global hypokinesia (n = 12) and was reversible in the majority of cases. Twelve patients had a circumferential pattern of RWMA in concordance with Takotsubo syndrome. Crude 30 day mortality was higher in patients with LV dysfunction and non-cardiac disease compared with patients with normal LV function (33% vs. 18%, P = 0.023), but not after risk adjustment (primary outcome) {odds ratio [OR] 1.56 [confidence interval (CI) 0.75\u20133.39], P = 0.225}. At 90 days, crude mortality was 44% and 22% (P = 0.002), respectively, in these groups. This difference was also significant after risk adjustment [OR 2.40 (CI 1.18\u20134.88), P = 0.016].<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Left ventricular systolic dysfunction is commonly triggered by critical illness, is frequently seen as regional hypokinesia, and is linked to an increased risk of death. The prognostic importance of LV dysfunction in critical illness might be underestimated.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.13633","type":"journal-article","created":{"date-parts":[[2021,10,5]],"date-time":"2021-10-05T20:10:23Z","timestamp":1633464623000},"page":"5415-5423","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Regional Left Ventricular Systolic Dysfunction Associated with Critical Illness: Incidence and Effect on Outcome"],"prefix":"10.1093","volume":"8","author":[{"given":"Oscar","family":"Cavefors","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, Sahlgrenska Academy, University of Gothenburg , Bl\u00e5 str\u00e5ket 5, v\u00e5n 5, Gothenburg, 413 45 ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Holmqvist","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, Sahlgrenska Academy, University of Gothenburg , Bl\u00e5 str\u00e5ket 5, v\u00e5n 5, Gothenburg, 413 45 ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Odd","family":"Bech-Hanssen","sequence":"additional","affiliation":[{"name":"Department of Clinical Physiology, Sahlgrenska Academy, University of Gothenburg , Gothenburg ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Freyr","family":"Einarsson","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, Sahlgrenska Academy, University of Gothenburg , Bl\u00e5 str\u00e5ket 5, v\u00e5n 5, Gothenburg, 413 45 ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Norberg","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, Sahlgrenska Academy, University of Gothenburg , Bl\u00e5 str\u00e5ket 5, v\u00e5n 5, Gothenburg, 413 45 ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Lundin","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, Sahlgrenska Academy, University of Gothenburg , Bl\u00e5 str\u00e5ket 5, v\u00e5n 5, Gothenburg, 413 45 ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elmir","family":"Omerovic","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Sahlgrenska Academy, University of Gothenburg , Gothenburg ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven-Erik","family":"Ricksten","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, Sahlgrenska Academy, University of Gothenburg , Bl\u00e5 str\u00e5ket 5, v\u00e5n 5, Gothenburg, 413 45 ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bj\u00f6rn","family":"Redfors","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Sahlgrenska Academy, University of Gothenburg , Gothenburg ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonatan","family":"Oras","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, Sahlgrenska Academy, University of Gothenburg , Bl\u00e5 str\u00e5ket 5, v\u00e5n 5, Gothenburg, 413 45 ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,10,4]]},"reference":[{"key":"2026012114192883800_ehf213633-bib-0001","doi-asserted-by":"crossref","first-page":"2129","DOI":"10.1093\/eurheartj\/ehw128","article-title":"2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) Developed with the special contribution of the Heart Failure Association (HFA) of the ESC","volume":"37","author":"Ponikowski","year":"2016","journal-title":"Eur Heart J."},{"key":"2026012114192883800_ehf213633-bib-0002","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1002\/ejhf.260","article-title":"Clinical picture and risk prediction of short-term mortality in cardiogenic shock","volume":"17","author":"Harjola","year":"2015","journal-title":"Eur J Heart Fail"},{"key":"2026012114192883800_ehf213633-bib-0003","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1002\/ejhf.646","article-title":"Cardiogenic shock in intensive care units: evolution of prevalence, patient profile, management and outcomes, 1997\u20132012","volume":"19","author":"Puymirat","year":"2017","journal-title":"Eur J Heart Fail."},{"key":"2026012114192883800_ehf213633-bib-0004","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.2217\/bmm-2018-0186","article-title":"High-sensitivity troponin T is a prognostic marker of hemodynamic instability in patients undergoing valve surgery","volume":"12","author":"Duchnowski","year":"2018","journal-title":"Biomarkers Med."},{"key":"2026012114192883800_ehf213633-bib-0005","doi-asserted-by":"crossref","first-page":"bio036251","DOI":"10.1242\/bio.036251","article-title":"Red cell distribution width as a predictor of multiple organ dysfunction syndrome in patients undergoing heart valve surgery","volume":"7","author":"Duchnowski","year":"2018","journal-title":"Biol Open."},{"key":"2026012114192883800_ehf213633-bib-0006","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1186\/s13054-018-2043-8","article-title":"Pathophysiology, echocardiographic evaluation, biomarker findings, and prognostic implications of septic cardiomyopathy: a review of the literature","volume":"22","author":"Ehrman","year":"2018","journal-title":"Crit Care."},{"key":"2026012114192883800_ehf213633-bib-0007","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.resuscitation.2018.01.019","article-title":"Echocardiographic patterns of postresuscitation myocardial dysfunction","volume":"124","author":"Cha","year":"2018","journal-title":"Resuscitation."},{"key":"2026012114192883800_ehf213633-bib-0008","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1007\/s12028-015-0108-y","article-title":"High-sensitive troponin T and N-Terminal pro B-type natriuretic peptide for early detection of stress-induced cardiomyopathy in patients with subarachnoid hemorrhage","volume":"23","author":"Oras","year":"2015","journal-title":"Neurocritical care."},{"key":"2026012114192883800_ehf213633-bib-0009","doi-asserted-by":"crossref","first-page":"2644","DOI":"10.3390\/jcm9082644","article-title":"Heart failure is highly prevalent and difficult to diagnose in severe exacerbations of COPD presenting to the emergency department","volume":"9","author":"Tin\u00e8","year":"2020","journal-title":"J Clin Med."},{"key":"2026012114192883800_ehf213633-bib-0010","doi-asserted-by":"crossref","first-page":"1459","DOI":"10.1378\/chest.108.5.1459","article-title":"Myocardial stunning following respiratory arrest","volume":"108","author":"Bashir","year":"1995","journal-title":"Chest"},{"key":"2026012114192883800_ehf213633-bib-0011","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1056\/NEJMoa1406761","article-title":"Clinical features and outcomes of Takotsubo (Stress) cardiomyopathy","volume":"373","author":"Templin","year":"2015","journal-title":"New Engl J Med."},{"key":"2026012114192883800_ehf213633-bib-0012","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1378\/chest.114.1.98","article-title":"Reversible myocardial contraction abnormalities in patients with an acute noncardiac illness","volume":"114","author":"Sharkey","year":"1998","journal-title":"Chest"},{"key":"2026012114192883800_ehf213633-bib-0013","doi-asserted-by":"crossref","first-page":"1333","DOI":"10.1016\/j.jtcvs.2019.06.070","article-title":"Left ventricular dysfunction in potential heart donors and its influence on recipient outcomes","volume":"159","author":"Oras","year":"2020","journal-title":"J Thoracic Cardiovasc Surgery."},{"key":"2026012114192883800_ehf213633-bib-0014","doi-asserted-by":"crossref","first-page":"914","DOI":"10.1111\/aas.12940","article-title":"Takotsubo syndrome in hemodynamically unstable patients admitted to the intensive care unit - a retrospective study","volume":"61","author":"Oras","year":"2017","journal-title":"Acta anaesthesiologica Scandinavica."},{"key":"2026012114192883800_ehf213633-bib-0015","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1016\/j.acvd.2019.11.005","article-title":"Incidence, clinical features and outcome of Takotsubo syndrome in the intensive care unit","volume":"113","author":"Doyen","year":"2020","journal-title":"Arch Cardiovasc Dis."},{"key":"2026012114192883800_ehf213633-bib-0016","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/j.jcrc.2003.10.008","article-title":"Reversible myocardial dysfunction, a possible complication in critically ill patients without heart disease","volume":"18","author":"Ruiz Bail\u00e9n","year":"2003","journal-title":"J Crit Care."},{"key":"2026012114192883800_ehf213633-bib-0017","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1378\/chest.128.1.296","article-title":"Left ventricular apical ballooning due to severe physical stress in patients admitted to the medical ICU","volume":"128","author":"Park","year":"2005","journal-title":"Chest."},{"key":"2026012114192883800_ehf213633-bib-0018","doi-asserted-by":"crossref","first-page":"1370","DOI":"10.1378\/chest.122.4.1370","article-title":"Range and prevalence of cardiac abnormalities in patients hospitalized in a medical ICU","volume":"122","author":"Bossone","year":"2002","journal-title":"Chest."},{"key":"2026012114192883800_ehf213633-bib-0019","doi-asserted-by":"crossref","first-page":"e37","DOI":"10.1016\/j.ejim.2008.09.015","article-title":"Routine transthoracic echocardiography in a general Intensive Care Unit: an 18 month survey in 704 patients","volume":"20","author":"Marcelino","year":"2009","journal-title":"Eur J Int Med."},{"key":"2026012114192883800_ehf213633-bib-0020","first-page":"65","article-title":"Risks and complications of coronary angiography: a comprehensive review","volume":"4","author":"Tavakol","year":"2012","journal-title":"Glob J Health Sci."},{"key":"2026012114192883800_ehf213633-bib-0021","doi-asserted-by":"crossref","first-page":"1336","DOI":"10.1007\/s00134-005-2762-6","article-title":"SAPS 3--From evaluation of the patient to evaluation of the intensive care unit. Part 1: Objectives, methods and cohort description","volume":"31","author":"Metnitz","year":"2005","journal-title":"Int Care Med."},{"key":"2026012114192883800_ehf213633-bib-0022","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1007\/s001340050931","article-title":"The use of maximum SOFA score to quantify organ dysfunction\/failure in intensive care. Results of a prospective, multicentre study","volume":"25","author":"Moreno","year":"1999","journal-title":"Int Care Med."},{"key":"2026012114192883800_ehf213633-bib-0023","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1001\/jama.2016.0287","article-title":"The third international consensus definitions for sepsis and septic shock (sepsis-3)","volume":"315","author":"Singer","year":"2016","journal-title":"JAMA."},{"key":"2026012114192883800_ehf213633-bib-0024","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1093\/ejechocard\/jen174","article-title":"European Association of Echocardiography recommendations for standardization of performance, digital storage and reporting of echocardiographic studies","volume":"9","author":"Evangelista","year":"2008","journal-title":"Eur J Echocardiogr."},{"key":"2026012114192883800_ehf213633-bib-0025","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.echo.2014.10.003","article-title":"Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging","volume":"28","author":"Lang","year":"2015","journal-title":"J Am Soc Echocardiogr."},{"key":"2026012114192883800_ehf213633-bib-0026","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1177\/0310057X0503300411","article-title":"Transthoracic echocardiography: impact on diagnosis and management in tertiary care intensive care units","volume":"33","author":"Stanko","year":"2005","journal-title":"Anaesth Intensive Care"},{"key":"2026012114192883800_ehf213633-bib-0027","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0002-8703(07)80003-2","article-title":"Long-term effects of acute thrombolytic therapy on ventricular size and function","volume":"126","author":"Picard","year":"1993","journal-title":"Am Heart J."},{"key":"2026012114192883800_ehf213633-bib-0028","doi-asserted-by":"crossref","first-page":"1262","DOI":"10.1002\/ehf2.12517","article-title":"Silent left ventricular apical ballooning and Takotsubo cardiomyopathy in an Australian intensive care unit","volume":"6","author":"Rowell","year":"2019","journal-title":"ESC Heart Fail."},{"key":"2026012114192883800_ehf213633-bib-0029","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1001\/jamacardio.2016.0225","article-title":"Differences in the clinical profile and outcomes of typical and atypical Takotsubo syndrome: data from the International Takotsubo Registry","volume":"1","author":"Ghadri","year":"2016","journal-title":"JAMA Cardiol."},{"key":"2026012114192883800_ehf213633-bib-0030","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1016\/j.ijcard.2014.07.110","article-title":"Out-of-hospital versus in-hospital Takotsubo cardiomyopathy: analysis of 3719 patients in the Diagnosis Procedure Combination database in Japan","volume":"176","author":"Isogai","year":"2014","journal-title":"Int J Cardiol."},{"key":"2026012114192883800_ehf213633-bib-0031","doi-asserted-by":"crossref","first-page":"2032","DOI":"10.1093\/eurheartj\/ehy076","article-title":"International expert consensus document on Takotsubo Syndrome (Part I): clinical characteristics, diagnostic criteria, and pathophysiology","volume":"39","author":"Ghadri","year":"2018","journal-title":"Eur Heart J."},{"key":"2026012114192883800_ehf213633-bib-0032","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1111\/echo.13879","article-title":"Speckle tracking analysis in intensive care unit: A toy or a tool?","volume":"35","author":"D'Andrea","year":"2018","journal-title":"Echocardiography."},{"key":"2026012114192883800_ehf213633-bib-0033","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1111\/aas.13272","article-title":"Speckle tracking-vs conventional echocardiography for the detection of myocardial injury-A study on patients with subarachnoid haemorrhage","volume":"63","author":"Dalla","year":"2019","journal-title":"Acta anaesthesiologica Scandinavica."}],"container-title":["ESC Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ehf2.13633","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ehf2.13633","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/8\/6\/5415\/65569163\/eschf_8_6_5415.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/8\/6\/5415\/65569163\/eschf_8_6_5415.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T19:23:19Z","timestamp":1769023399000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eschf\/article\/8\/6\/5415\/8343710"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,4]]},"references-count":33,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021,10,4]]},"published-print":{"date-parts":[[2021,12,1]]}},"URL":"https:\/\/doi.org\/10.1002\/ehf2.13633","relation":{},"ISSN":["2055-5822"],"issn-type":[{"value":"2055-5822","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,12]]},"published":{"date-parts":[[2021,10,4]]},"assertion":[{"value":"2021-06-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-09-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-10-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}