Echocardiographic assessment identifies long-term myocardial dysfunction in patients with burns, sepsis, and traumaHeart Damage Found in Patients with Burns, Sepsis, and Trauma

Shock (Augusta, Ga.) Published November 4, 2026 Study authors: Niederegger Tobias, Karakas Emre, Schaschinger Thomas, Brandt Jule, Knoedler Leonard, Maheta Bhagvat… PubMed ↗ DOI ↗ Editorial oversight: Dr. Lars van Dijk, PhD · Surgical, Procedural & Diagnostic

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Key Takeaway

Recognize that echocardiographic signs of myocardial dysfunction occur in patients with burns, sepsis, and trauma.

This meta-analysis synthesizes data from 47 studies involving 3,117 patients with severe burns (n=1,876), sepsis (n=959), and trauma (n=282) to evaluate echocardiographic signs of long-term cardiac dysfunction. The analysis identifies myocardial dysfunction across all three conditions, noting that these signs were most pronounced in burn survivors. Secondary outcomes such as left ventricular ejection fraction (LVEF) were reported in 73% of studies, while heart rate (HR) and E/A ratio were reported in 23% and 29% of studies, respectively.

The authors note significant limitations, including substantial heterogeneity in patient severity, study design, and echocardiographic assessment methods. Furthermore, follow-up durations were notably short for sepsis (median 9 days) and trauma (median 10 days) compared to burns (median 447 days). There is also a noted lack of longitudinal data for trauma and sepsis patients.

For clinical practice, these findings highlight the presence of myocardial dysfunction following these acute conditions, particularly in burn patients. However, the high level of heterogeneity and the need for standardized echocardiographic protocols suggest that these findings should be interpreted with caution until more prospective, standardized studies are available.

How this fits prior evidence

This meta-analysis addresses a gap in the understanding of cardiac outcomes following critical illness. While previous evidence highlights the severity of sepsis, such as the association of high THBS1 expression with poorer outcomes and the impact of malignancy on mortality, this study specifically focuses on the long-term myocardial dysfunction following sepsis, burns, and trauma. It provides evidence of cardiac involvement in these populations, though it does not directly relate to the specific mechanisms of immunoparalysis or the efficacy of sivelestat-containing regimens mentioned in prior coverage.

A large review of data from over 3,000 patients looked at heart health after severe medical events. The study focused on patients who had suffered from major trauma, sepsis, or severe burns. Researchers used ultrasound images of the heart to check for signs of long-term muscle problems.

The findings showed that heart muscle dysfunction was present in all three groups. However, these issues were most noticeable in patients who survived severe burns. While the study included a large number of patients, the data for trauma and sepsis patients were collected over a shorter period than the data for burn patients.

Because the studies included in this review varied greatly in how they measured heart health and how long they followed patients, the results should be viewed with caution. The study highlights that while heart issues are common after these severe conditions, more consistent research is needed to understand the full impact. Patients should talk to their doctors about heart health monitoring after a major injury or illness.

What this means for you:

Heart muscle issues were found in patients with burns, sepsis, and trauma, especially among burn survivors.

Common questions

What did the study find about heart health after a severe burn?

The study found that heart muscle dysfunction occurred in all three conditions studied. However, these signs of long-term heart issues were most pronounced in patients who survived severe burns. Because of the variety in how studies were designed, these results are a starting point for understanding heart health after major injuries.

How many patients were included in this research?

The study included a total of 3,117 patients. This group consisted of 1,876 patients with burns, 959 patients with sepsis, and 282 patients who experienced major trauma. These numbers provide a broad look at how different severe conditions can affect the heart.

Why is more research needed for these conditions?

The researchers noted that the studies they reviewed had many differences in how they chose patients and measured heart health. Specifically, there was very little long-term data for trauma and sepsis patients. More consistent, long-term studies are needed to provide clearer information for medical practice.

Study Details

Study typeMeta analysis

Sample sizen = 3,117

EvidenceLevel 1

PublishedNov 2026

PMID41949827

View Original Abstract ↓

Severe burns, major trauma, and sepsis cause systemic inflammation and metabolic stress, often leading to acute cardiac dysfunction. How myocardial sequelae evolve over time remains unclear. This meta-analysis evaluated whether consistent echocardiographic patterns of long-term dysfunction exist across these conditions and whether current data permit longitudinal comparison. A systematic search of PubMed, EMBASE, Web of Science, Cochrane, and Google Scholar (inception to July 2025) followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Eligible studies reported echocardiographic outcomes ≥72 h after injury or sepsis onset. Data on demographics, illness severity, and echocardiographic parameters were extracted. Subgroup and meta-analyses compared conditions and follow-up periods. In this meta-analysis of 47 studies (n = 3,117; trauma: 282, sepsis: 959, burns: 1,876) left ventricular ejection fraction (LVEF), heart rate (HR), and E/A ratio were the most common echocardiographic parameters. LVEF was reported in n = 35 (73%) studies: n = 9 (19%) trauma, n = 17 (35%) sepsis, and n = 9 (19%) burn studies, limited by substantial heterogeneity in patient severity and follow-up timing. The same applies to HR, reported in n = 11 (23%) studies [n = 3 (6.3%) trauma, n = 5 (10%) sepsis, and n = 3 (6.3%) burn studies], and E/A ratio reported in n = 14 (29%) studies [n = 4 (8.3%) trauma, n = 6 (13%) sepsis, and n = 4 (8.3%) burn studies]. Marked heterogeneity in study design, patient selection, and echocardiographic assessment limited direct comparability across conditions. Despite signals of long-term alteration, analysis was restricted by short follow-up durations (median 9 days for sepsis, 10 for trauma, and 447 for burns) and scarce longitudinal data, particularly in trauma and sepsis cohorts. This meta-analysis identifies long-term myocardial dysfunction after burns, sepsis, and trauma, most pronounced in burn survivors. Marked heterogeneity and limited longitudinal data hinder trajectory assessment. Prospective studies with standardized echocardiography are needed to define postcritical illness cardiac phenotypes.

Echocardiographic assessment identifies long-term myocardial dysfunction in patients with burns, sepsis, and traumaHeart Damage Found in Patients with Burns, Sepsis, and Trauma

How this fits prior evidence

Common questions

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Echocardiographic assessment identifies long-term myocardial dysfunction in patients with burns, sepsis, and traumaHeart Damage Found in Patients with Burns, Sepsis, and Trauma

How this fits prior evidence

Common questions

More on Sepsis

Study Details

Intraosseous route for out-of-hospital cardiac arrest linked to lower outcomes than intravenous access

Using a bone needle instead of a vein line lowers survival chances for cardiac arrest patients

Clinical research that matters. Delivered to your inbox.

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