Sepsis-Induced Myocardial Dysfunction and Its Prognostic Implications for Mortality in the Intensive Care Unit: A Systematic Review.

Sepsis-induced myocardial dysfunction (SIMD) is increasingly recognized as a critical determinant of morbidity in intensive care unit (ICU) patients, yet its direct impact on mortality remains uncertain. This systematic review synthesized evidence from randomized controlled trials and observational studies investigating the association between SIMD and outcomes in septic patients. Echocardiographic and biomarker-based assessments consistently demonstrated that SIMD is a frequent and often reversible complication of sepsis, associated with greater disease severity and impaired hemodynamics. Pharmacological interventions such as levosimendan and Xinmailong infusion were found to improve surrogate measures of cardiac function, yet none conferred a significant survival benefit at 28 days. While advanced imaging modalities like speckle-tracking echocardiography enhanced diagnostic sensitivity, heterogeneity in study design, patient populations, and outcome definitions limited the strength of pooled conclusions. Overall, SIMD appears to be a clinically relevant marker of illness severity, but current evidence does not establish it as an independent predictor of mortality. Larger multicenter trials with standardized diagnostic frameworks and long-term follow-up are required to clarify its prognostic role and to determine whether targeted therapies can alter patient outcomes.