Correlation between tissue Doppler-derived left ventricular systolic velocity (S') and left ventricle ejection fraction in sepsis and septic shock: a retrospective cohort study.

IF 3.8 2区医学 Q1 CRITICAL CARE MEDICINE

Journal of Intensive Care Pub Date : 2023-07-03 DOI:10.1186/s40560-023-00678-z

Sanchit Chawla, Ryota Sato, Abhijit Duggal, Mahmoud Alwakeel, Daisuke Hasegawa, Dina Alayan, Patrick Collier, Filippo Sanfilippo, Michael Lanspa, Siddharth Dugar

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Abstract

Background: Tissue Doppler-derived left ventricular systolic velocity (mitral S') has shown excellent correlation to left ventricular ejection fraction (LVEF) in non-critically patients. However, their correlation in septic patients remains poorly understood and its impact on mortality is undetermined. We investigated the relationship between mitral S' and LVEF in a large cohort of critically-ill septic patients.

Methods: We conducted a retrospective cohort study between 01/2011 and 12/2020. All adult patients (≥ 18 years) who were admitted to the medical intensive care unit (MICU) with sepsis and septic shock that underwent a transthoracic echocardiogram (TTE) within 72 h were included. Pearson correlation test was used to assess correlation between average mitral S' and LVEF. Pearson correlation was used to assess correlation between average mitral S' and LVEF. We also assessed the association between mitral S', LVEF and 28-day mortality.

Results: 2519 patients met the inclusion criteria. The study population included 1216 (48.3%) males with a median age of 64 (IQR: 53-73), and a median APACHE III score of 85 (IQR: 67, 108). The median septal, lateral, and average mitral S' were 8 cm/s (IQR): 6.0, 10.0], 9 cm/s (IQR: 6.0, 10.0), and 8.5 cm/s (IQR: 6.5, 10.5), respectively. Mitral S' was noted to have moderate correlation with LVEF (r = 0.46). In multivariable logistic regression analysis, average mitral S' was associated with an increase in both 28-day ICU and in-hospital mortality with odds ratio (OR) 1.04 (95% CI 1.01-1.08, p = 0.02) and OR 1.04 (95% CI 1.01-1.07, p = 0.02), respectively.

Conclusions: Even though mitral S' and LVEF may be related, they are not exchangeable and were only found to have moderate correlation in this study. LVEF is U-shaped, while mitral S' has a linear relation with 28-day ICU mortality. An increase in average mitral S' was associated with higher 28-day mortality.

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脓毒症和感染性休克患者组织多普勒衍生左心室收缩速度(S’)和左心室射血分数的相关性:一项回顾性队列研究

背景:组织多普勒衍生的左心室收缩速度(二尖瓣S')与非危重患者左心室射血分数(LVEF)有很好的相关性。然而，它们在脓毒症患者中的相关性仍然知之甚少，其对死亡率的影响尚不确定。我们研究了一大批重症脓毒症患者二尖瓣S'和LVEF之间的关系。方法:2011年1月至2020年12月进行回顾性队列研究。所有因脓毒症和脓毒性休克入住医学重症监护病房(MICU)并在72小时内接受经胸超声心动图(TTE)检查的成年患者(≥18岁)均被纳入研究。采用Pearson相关检验评价二尖瓣平均S′与LVEF的相关性。采用Pearson相关性评价二尖瓣平均S′与LVEF的相关性。我们还评估了二尖瓣S′、LVEF与28天死亡率之间的关系。结果:2519例患者符合纳入标准。研究人群包括1216名男性(48.3%)，中位年龄64岁(IQR: 53-73)，中位APACHE III评分为85 (IQR: 67, 108)。中间隔、侧二尖瓣和平均二尖瓣S′分别为8 cm/ S (IQR): 6.0、10.0,9 cm/ S (IQR: 6.0、10.0)和8.5 cm/ S (IQR: 6.5、10.5)。二尖瓣S′与LVEF有中度相关性(r = 0.46)。在多变量logistic回归分析中，平均二尖瓣S′与28天ICU和住院死亡率的增加相关，比值比(OR)分别为1.04 (95% CI 1.01-1.08, p = 0.02)和1.04 (95% CI 1.01-1.07, p = 0.02)。结论:尽管二尖瓣S′与LVEF可能存在相关性，但两者并不具有互换性，本研究仅发现两者存在中度相关性。LVEF呈u型，二尖瓣S′与28天ICU死亡率呈线性关系。二尖瓣S′平均升高与28天死亡率升高有关。

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来源期刊

Journal of Intensive Care Medicine-Critical Care and Intensive Care Medicine

CiteScore

11.90

自引率

1.40%

发文量

审稿时长

15 weeks

期刊介绍： "Journal of Intensive Care" is an open access journal dedicated to the comprehensive coverage of intensive care medicine, providing a platform for the latest research and clinical insights in this critical field. The journal covers a wide range of topics, including intensive and critical care, trauma and surgical intensive care, pediatric intensive care, acute and emergency medicine, perioperative medicine, resuscitation, infection control, and organ dysfunction. Recognizing the importance of cultural diversity in healthcare practices, "Journal of Intensive Care" also encourages submissions that explore and discuss the cultural aspects of intensive care, aiming to promote a more inclusive and culturally sensitive approach to patient care. By fostering a global exchange of knowledge and expertise, the journal contributes to the continuous improvement of intensive care practices worldwide.