Value of speckle-tracking echocardiography changes in monitoring myocardial dysfunction during treatment of sepsis: potential prognostic implications
- 128 Downloads
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.
KeywordsSepsis Cardiovascular function Speckle tracking echocardiography Longitudinal strain Ventricular function
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.
- 4.Vallabhajosyula S, Sakhuja A, Geske JB, Kumar M, Poterucha JT, Kashyap R et al (2017) Role of admission troponin-T and serial troponin-T testing in predicting outcomes in severe sepsis and septic shock. J Am Heart Assoc 6Google Scholar
- 12.Vallabhajosyula S, Rayes HA, Sakhuja A, Murad MH, Geske JB, Jentzer JC (2018) Global longitudinal strain using speckle-tracking echocardiography as a mortality predictor in sepsis: a systematic review. J Intensiv Care Med 885066618761750Google Scholar
- 14.Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L et al (2015) Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 16:233–270CrossRefPubMedGoogle Scholar
- 16.Morris DA, Krisper M, Nakatani S, Kohncke C, Otsuji Y, Belyavskiy E et al (2017) Normal range and usefulness of right ventricular systolic strain to detect subtle right ventricular systolic abnormalities in patients with heart failure: a multicentre study. Eur Heart J Cardiovasc Imaging 18:212–223CrossRefPubMedGoogle Scholar