Pham Dang Hai, Le Lan Phuong, Nguyen Manh Dung, Le Thi Viet Hoa, Do Van Quyen, Nguyen Xuan Chinh, Vu Duy Minh, Pham Nguyen Son
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Patients with other causes of cardiac dysfunction were excluded. Transthoracic echocardiography was performed for all the patients within 24 hours of diagnosis. Left ventricular systolic function was assessed using conventional echocardiography and speckle-tracking echocardiography.</p><p><strong>Results: </strong>Patients with septic shock (<i>n</i> = 90) (study group) and 37 matched patients with sepsis but no septic shock (control group) were included. Left ventricular ejection fraction (LVEF) by conventional echocardiography showed no significant difference between two groups (58.2 ± 9.9 vs. 58.6 ± 8.3, <i>p</i>=0.804). The global longitudinal strain (GLS) by STE was significantly reduced in patients with septic shock compared with that in the control (-14.6 ± 3.3 vs. -17.1 ± 3.3, <i>p</i> < 0.001). Based on the cutoff value of GLS ≥ -15% for the definition of subclinical left ventricular systolic dysfunction, this dysfunction was detected in 50 patients with septic shock (55.6%) and in 6 patients in the control group (16.2%) (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>Speckle-tracking echocardiography can detect early subclinical left ventricular systolic dysfunction via the left ventricular global longitudinal strain compared with conventional echocardiographic parameters in patients with septic shock.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":"2020 ","pages":"6098654"},"PeriodicalIF":1.8000,"publicationDate":"2020-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/6098654","citationCount":"10","resultStr":"{\"title\":\"Subclinical Left Ventricular Systolic Dysfunction in Patients with Septic Shock Based on Sepsis-3 Definition: A Speckle-Tracking Echocardiography Study.\",\"authors\":\"Pham Dang Hai, Le Lan Phuong, Nguyen Manh Dung, Le Thi Viet Hoa, Do Van Quyen, Nguyen Xuan Chinh, Vu Duy Minh, Pham Nguyen Son\",\"doi\":\"10.1155/2020/6098654\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Left ventricular dysfunction is quite common in septic shock. Speckle-tracking echocardiography (STE) is a novel, highly sensitive method for assessing left ventricular function, capable of detecting subclinical myocardial dysfunction, which is not identified with conventional echocardiography. We sought to evaluate subclinical left ventricular systolic function in patients with septic shock using speckle-tracking echocardiography.</p><p><strong>Methods: </strong>From May 2017 to December 2018, patients aged ≥18 years admitted to the intensive care unit with the diagnosis of sepsis and septic shock based on the sepsis-3 definition were included. Patients with other causes of cardiac dysfunction were excluded. Transthoracic echocardiography was performed for all the patients within 24 hours of diagnosis. Left ventricular systolic function was assessed using conventional echocardiography and speckle-tracking echocardiography.</p><p><strong>Results: </strong>Patients with septic shock (<i>n</i> = 90) (study group) and 37 matched patients with sepsis but no septic shock (control group) were included. Left ventricular ejection fraction (LVEF) by conventional echocardiography showed no significant difference between two groups (58.2 ± 9.9 vs. 58.6 ± 8.3, <i>p</i>=0.804). The global longitudinal strain (GLS) by STE was significantly reduced in patients with septic shock compared with that in the control (-14.6 ± 3.3 vs. -17.1 ± 3.3, <i>p</i> < 0.001). Based on the cutoff value of GLS ≥ -15% for the definition of subclinical left ventricular systolic dysfunction, this dysfunction was detected in 50 patients with septic shock (55.6%) and in 6 patients in the control group (16.2%) (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>Speckle-tracking echocardiography can detect early subclinical left ventricular systolic dysfunction via the left ventricular global longitudinal strain compared with conventional echocardiographic parameters in patients with septic shock.</p>\",\"PeriodicalId\":46583,\"journal\":{\"name\":\"Critical Care Research and Practice\",\"volume\":\"2020 \",\"pages\":\"6098654\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2020-09-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1155/2020/6098654\",\"citationCount\":\"10\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Critical Care Research and Practice\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1155/2020/6098654\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2020/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"CRITICAL CARE MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Critical Care Research and Practice","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1155/2020/6098654","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2020/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
引用次数: 10
摘要
简介:左心室功能障碍在感染性休克中很常见。斑点跟踪超声心动图(STE)是一种新型的、高灵敏度的左心室功能评估方法，能够检测到常规超声心动图无法识别的亚临床心肌功能障碍。我们试图用斑点跟踪超声心动图评价脓毒性休克患者的亚临床左心室收缩功能。方法:选取2017年5月至2018年12月重症监护病房收治的年龄≥18岁、根据脓毒症-3定义诊断为脓毒症和脓毒性休克的患者。排除其他心功能障碍的患者。所有患者均在诊断后24小时内行经胸超声心动图检查。采用常规超声心动图和斑点跟踪超声心动图评价左心室收缩功能。结果:纳入脓毒性休克患者(n = 90)(研究组)和37例匹配的脓毒症但无脓毒性休克患者(对照组)。常规超声心动图左室射血分数(LVEF)两组比较差异无统计学意义(58.2±9.9比58.6±8.3,p=0.804)。脓毒性休克组经STE处理的总纵向应变(GLS)较对照组显著降低(-14.6±3.3 vs -17.1±3.3,p < 0.001)。以GLS≥-15%定义亚临床左室收缩功能障碍的临界值为标准，感染性休克患者50例(55.6%)，对照组6例(16.2%)存在亚临床左室收缩功能障碍(p < 0.05)。结论:与常规超声心动图参数相比，斑点跟踪超声心动图可通过左室总纵应变检测出感染性休克患者早期亚临床左室收缩功能障碍。
Subclinical Left Ventricular Systolic Dysfunction in Patients with Septic Shock Based on Sepsis-3 Definition: A Speckle-Tracking Echocardiography Study.
Introduction: Left ventricular dysfunction is quite common in septic shock. Speckle-tracking echocardiography (STE) is a novel, highly sensitive method for assessing left ventricular function, capable of detecting subclinical myocardial dysfunction, which is not identified with conventional echocardiography. We sought to evaluate subclinical left ventricular systolic function in patients with septic shock using speckle-tracking echocardiography.
Methods: From May 2017 to December 2018, patients aged ≥18 years admitted to the intensive care unit with the diagnosis of sepsis and septic shock based on the sepsis-3 definition were included. Patients with other causes of cardiac dysfunction were excluded. Transthoracic echocardiography was performed for all the patients within 24 hours of diagnosis. Left ventricular systolic function was assessed using conventional echocardiography and speckle-tracking echocardiography.
Results: Patients with septic shock (n = 90) (study group) and 37 matched patients with sepsis but no septic shock (control group) were included. Left ventricular ejection fraction (LVEF) by conventional echocardiography showed no significant difference between two groups (58.2 ± 9.9 vs. 58.6 ± 8.3, p=0.804). The global longitudinal strain (GLS) by STE was significantly reduced in patients with septic shock compared with that in the control (-14.6 ± 3.3 vs. -17.1 ± 3.3, p < 0.001). Based on the cutoff value of GLS ≥ -15% for the definition of subclinical left ventricular systolic dysfunction, this dysfunction was detected in 50 patients with septic shock (55.6%) and in 6 patients in the control group (16.2%) (p < 0.05).
Conclusions: Speckle-tracking echocardiography can detect early subclinical left ventricular systolic dysfunction via the left ventricular global longitudinal strain compared with conventional echocardiographic parameters in patients with septic shock.
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