Frequency of Myocardial Dysfunction in Neonatal Sepsis: A Single Center Experience

Background: Myocardial dysfunction is an association of neonatal sepsis that might occur without underlying cardiac structural defect (CSD). Aims of the work: To study frequency of myocardial dysfunction (MD) in sepsis in full term neonates without CSD. Subjects and Methods: All the full term neonates with neonatal sepsis admitted to Neonatal Intensive Care Unit, Fayoum University between December 2019 and December 2020 without underlying CSD were included in the study. They underwent conventional echocardiography and tissue Doppler studies. Results: 103 neonates with neonatal sepsis were included in the study. Of them 30 patients (29.12%) were found to have myocardial dysfunction. Global myocardial dysfunction was encountered in 16 (53.3%), isolated right ventricle dysfunction in 8 (26.6%) cases, isolated left ventricle dysfunction among 6 (20%). The dysfunction was both systolic and diastolic in 2 (6.6%) cases, isolated systolic in 6 (20%), and isolated diastolic in 22 (73.3 %). No noted risk factors were associated with myocardial dysfunction as age (p=0.193), weight (p=0.100), sex (p=0.130) or type of bacterial infection (p=0.125). The outcome among those with myocardial dysfunction and those without was complete resolution in 13 (43.3%) and 43 (59%) patients (p=0.149), cardiogenic shock and death in 17 cases (56.7%) and 30 (41%) (p=0.149) respectively while no cases developed progressive cardiomyopathy. Conclusions: Full terms with neonatal sepsis can experience significant cardiovascular dysfunction that is either global or limited to right or left ventricle. The dysfunction might be systolic or diastolic or both. Myocardial dysfunction among neonates with sepsis might be self- limiting or culminates increasing the risk of mortality.