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Value of speckle-tracking echocardiography changes in monitoring myocardial dysfunction during treatment of sepsis: potential prognostic implications

  • Mariana de Braga Lima Carvalho Canesso
  • Isabela Nascimento Borges
  • Thiago Adriano de Deus Queiroz Santos
  • Tijmen Hermen Ris
  • Marcio Vinicius Lins de Barros
  • Vandack Nobre
  • Maria Carmo Pereira NunesEmail author
Original Paper

Abstract

Speckle-tracking echocardiography (STE) has been increasingly used for detection of sepsis-related myocardial dysfunction. However, the impact of strain changes during sepsis treatment has not been defined. This study assessed STE at admission and during the treatment of patients with sepsis to evaluate its changes as a potential factor for predicting in-hospital outcome. This study included 26 patients with sepsis who underwent STE echocardiography on day 1 and 7 during treatment. Myocardial deformation of both ventricles was assessed using global longitudinal strain. The endpoint was in-hospital mortality. The mean age was 51.4 ± 18.3 years, and 54% were female. The average SOFA score at T0 was 8.6 ± 3.8 points and at day 7 was 4.9 ± 4.7 points. The left ventricular (LV) ejection fraction at baseline was 65.6 ± 9.1%, without changes in echocardiographic parameters during treatment. LV and RV longitudinal strain increased significantly in the patients who survived (− 18.8 ± 3.6 at D1 vs − 20.8 ± 2.5 at D7; p = 0.003; and − 21.3 ± 4.9 at D1 vs − 24.3 ± 5.8 at D7; p = 0.035, respectively), whereas strain values remained unchanged in those who died. After adjustment for the SOFA score, RV longitudinal strain at admission was associated with in-hospital mortality [adjusted odds ratio (OR) 0.760; 95% confidence interval (CI) 0.591–0.977; p − 0.033]. STE improved significantly after the first week of treatment in patients with sepsis who survived compared with those patients who died during hospitalization. RV strain at admission predicted in-hospital mortality. An improvement in STE during sepsis treatment appears to be a useful tool for predicting in-hospital outcome.

Keywords

Sepsis Cardiovascular function Speckle tracking echocardiography Longitudinal strain Ventricular function 

Notes

Funding

CNPq (Brazilian Council for Scientific and Technological Development) partly supported the study.

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

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Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  • Mariana de Braga Lima Carvalho Canesso
    • 1
    • 2
    • 5
  • Isabela Nascimento Borges
    • 2
    • 5
  • Thiago Adriano de Deus Queiroz Santos
    • 2
  • Tijmen Hermen Ris
    • 3
  • Marcio Vinicius Lins de Barros
    • 4
  • Vandack Nobre
    • 1
    • 2
    • 5
  • Maria Carmo Pereira Nunes
    • 1
    • 2
    • 5
    Email author
  1. 1.Postgraduate Course of Infectious Diseases and Tropical Medicine, School of MedicineUniversidade Federal de Minas GeraisBelo HorizonteBrazil
  2. 2.Hospital das Clinicas, School of MedicineUniversidade Federal de Minas GeraisBelo HorizonteBrazil
  3. 3.Erasmus University Rotterdam -Erasmus MCRotterdamThe Netherlands
  4. 4.Mater Dei HospitalBelo HorizonteBrazil
  5. 5.Núcleo Interdiciplinar de Investigação em Medicina Intensiva (NIIMI)Belo HorizonteBrazil

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