Oscar Cavefors: Heart failure common among ICU patients


More than half of intensive care unit (ICU) patients suffer from heart failure, according to Oscar Cavefors’ doctoral thesis. He has also explored the causes of heart failure among ICU patients and analyzed the use of heart-specific blood tests.

Dissertation Defense: September 29, 2023
Doctoral Thesis: Left ventricular dysfunction in critically ill patients
Research Area: Anesthesiology and Intensive Care
Sahlgrenska Academy, The Institute of Clinical Sciences

What is the background to your thesis?
“Heart failure is common among patients in the intensive care unit. Heart failure can, in itself, be a reason for needing intensive care. However, we also see that patients develop heart failure during intensive care as a result of another severe illness, such as infection or brain bleeding,” says Oscar Cavefors, an anesthesiologist at Sahlgrenska University Hospital. “Despite this, little research has systematically examined how common this is among ICU patients and what causes this type of heart failure.”

Figure 2, page 2 in Oscar Cavefors’ doctoral thesis. Cardiac anatomy.

Heart failure increases the risk of death

The studies in Oscar Cavefors’ thesis investigate the prevalence of various types of heart failure among ICU patients.

“We have also studied if heart failure is associated with an increased risk of death and whether biomarkers can be used to predict if patients have heart failure or not. In addition, we have investigated potential causes of heart failure by studying coronary angiography and magnetic resonance imaging.”

What are your most significant research findings?
“Our most important finding is that heart failure is common in the ICU and can be seen in more than half of our patients. We were also able to link left ventricular dysfunction to an increased risk of death and show that a major part of left ventricular heart failure is not caused by coronary artery stenosis.”

Figure 7, page 35 in the thesis. Mortality depending on the presence of systolic left ventricular dysfunction in mixed ICU patients. Detailed caption and reference to previous publication are provided at the bottom.

“Exciting Opportunities”

What did the studies of heart-specific blood tests reveal?
“Elevated levels of biomarkers were clearly associated with the presence of heart dysfunction. However, the biomarkers were not precise enough to use for excluding heart failure,” says Oscar Cavefors.

Why did you choose to dedicate yourself to research?
“It is exciting to have the opportunity to investigate things you’ve been pondering and test your hypotheses. I also appreciate collaborating with colleagues and different research groups.”

Text: Jakob Lundberg

Caption for Figure 7 and reference

Mortality depending on the presence of systolic left ventricular dysfunction in mixed ICU patients. A) Stratified by primary heart-related or secondary heart failure. B) Stratified based on general or regional dysfunction. C) Stratified by left ventricular function and low cardiac output.

Reference: Reproduced from “Cavefors et al. Regional left ventricular systolic dysfunction associated with critical illness: incidence and effect on outcome. ESC Heart Fail 2021; 8: 5415-23. 311” with permission from John Wiley and Sons.