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Article: Speckle tracking echocardiography in patients with septic shock: A case control study (SPECKSS)

TitleSpeckle tracking echocardiography in patients with septic shock: A case control study (SPECKSS)
Authors
KeywordsSepsis-induced myocardial dysfunction
Septic cardiomyopathy
Septic shock
Speckle tracking echocardiography
Speckle tracking imaging
Strain
Sepsis
Global longitudinal strain
Issue Date2016
Citation
Critical Care, 2016, v. 20, n. 1, article no. 145 How to Cite?
Abstract© 2016 Ng et al. Background: Sepsis-induced myocardial dysfunction is a well-recognized condition and confers worse outcomes in septic patients. Echocardiographic assessment by conventional parameters such as left ventricular ejection fraction (LVEF) is often affected by ongoing changes in preload and afterload conditions. Novel echocardiographic technologies such as speckle tracking echocardiography (STE) have evolved for direct assessment of the myocardial function. We investigate the measurement of myocardial strain by speckle tracking echocardiography for the diagnosis of sepsis-induced myocardial dysfunction. Methods: This is a case-control study at a university-affiliated medical intensive care unit. Consecutive adult medical patients admitted with a diagnosis of septic shock were included. Patients with other causes of myocardial dysfunction were excluded. They were compared to age-matched, gender-matched, and cardiovascular risk-factor-matched controls, who were admitted to hospital for sepsis but did not develop septic shock. Transthoracic echocardiography was performed on all patients within 24 hours of diagnosis, and a reassessment echocardiogram was performed in the study group of patients upon recovery. Results: Patients with septic shock (n = 33) (study group) and 29 matched patients with sepsis but no septic shock (control group) were recruited. The mean sequential organ failure assessment (SOFA) score for the study and control groups were 10.2 and 1.6, respectively (P < 0.001). In patients with septic shock, the mean arterial pressure was lower (76 mmHg vs 82 mmHg, P = 0.032), and the heart rate was higher (99 bpm vs 86 bpm, P = 0.008). The cardiac output (5.9 L/min vs 5.5 L/min, P = 0.401) and systemic vascular resistance (1090 dynes·sec/cm5 vs 1194 dynes·sec/cm5, P = 0.303) were similar. The study group had a greater degree of myocardial dysfunction measured by global longitudinal strain (GLS) (-14.5 % vs -18.3 %, P <0.001), and the myocardial strain differed upon diagnosis and recovery (-14.5 % vs -16.0 %, P = 0.010). Conventional echocardiographic measurements such as LVEF (59 % in the study group vs 61 % in the control group, P = 0.169) did not differ between the two groups. Conclusion: Speckle tracking echocardiography can detect significant left ventricular impairment in patients with septic shock, which was not otherwise detectable by conventional echocardiography. The reversible nature of myocardial dysfunction in sepsis was also demonstrable. This echocardiographic technique is useful in the diagnosis and monitoring of sepsis-induced myocardial dysfunction.
Persistent Identifierhttp://hdl.handle.net/10722/285778
ISSN
2023 Impact Factor: 8.8
2023 SCImago Journal Rankings: 2.975
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorNg, Pauline Yeung-
dc.contributor.authorSin, Wai Ching-
dc.contributor.authorNg, Andrew Kei Yan-
dc.contributor.authorChan, Wai Ming-
dc.date.accessioned2020-08-18T04:56:37Z-
dc.date.available2020-08-18T04:56:37Z-
dc.date.issued2016-
dc.identifier.citationCritical Care, 2016, v. 20, n. 1, article no. 145-
dc.identifier.issn1364-8535-
dc.identifier.urihttp://hdl.handle.net/10722/285778-
dc.description.abstract© 2016 Ng et al. Background: Sepsis-induced myocardial dysfunction is a well-recognized condition and confers worse outcomes in septic patients. Echocardiographic assessment by conventional parameters such as left ventricular ejection fraction (LVEF) is often affected by ongoing changes in preload and afterload conditions. Novel echocardiographic technologies such as speckle tracking echocardiography (STE) have evolved for direct assessment of the myocardial function. We investigate the measurement of myocardial strain by speckle tracking echocardiography for the diagnosis of sepsis-induced myocardial dysfunction. Methods: This is a case-control study at a university-affiliated medical intensive care unit. Consecutive adult medical patients admitted with a diagnosis of septic shock were included. Patients with other causes of myocardial dysfunction were excluded. They were compared to age-matched, gender-matched, and cardiovascular risk-factor-matched controls, who were admitted to hospital for sepsis but did not develop septic shock. Transthoracic echocardiography was performed on all patients within 24 hours of diagnosis, and a reassessment echocardiogram was performed in the study group of patients upon recovery. Results: Patients with septic shock (n = 33) (study group) and 29 matched patients with sepsis but no septic shock (control group) were recruited. The mean sequential organ failure assessment (SOFA) score for the study and control groups were 10.2 and 1.6, respectively (P < 0.001). In patients with septic shock, the mean arterial pressure was lower (76 mmHg vs 82 mmHg, P = 0.032), and the heart rate was higher (99 bpm vs 86 bpm, P = 0.008). The cardiac output (5.9 L/min vs 5.5 L/min, P = 0.401) and systemic vascular resistance (1090 dynes·sec/cm5 vs 1194 dynes·sec/cm5, P = 0.303) were similar. The study group had a greater degree of myocardial dysfunction measured by global longitudinal strain (GLS) (-14.5 % vs -18.3 %, P <0.001), and the myocardial strain differed upon diagnosis and recovery (-14.5 % vs -16.0 %, P = 0.010). Conventional echocardiographic measurements such as LVEF (59 % in the study group vs 61 % in the control group, P = 0.169) did not differ between the two groups. Conclusion: Speckle tracking echocardiography can detect significant left ventricular impairment in patients with septic shock, which was not otherwise detectable by conventional echocardiography. The reversible nature of myocardial dysfunction in sepsis was also demonstrable. This echocardiographic technique is useful in the diagnosis and monitoring of sepsis-induced myocardial dysfunction.-
dc.languageeng-
dc.relation.ispartofCritical Care-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectSepsis-induced myocardial dysfunction-
dc.subjectSeptic cardiomyopathy-
dc.subjectSeptic shock-
dc.subjectSpeckle tracking echocardiography-
dc.subjectSpeckle tracking imaging-
dc.subjectStrain-
dc.subjectSepsis-
dc.subjectGlobal longitudinal strain-
dc.titleSpeckle tracking echocardiography in patients with septic shock: A case control study (SPECKSS)-
dc.typeArticle-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1186/s13054-016-1327-0-
dc.identifier.pmid27177587-
dc.identifier.pmcidPMC4867983-
dc.identifier.scopuseid_2-s2.0-84984636533-
dc.identifier.volume20-
dc.identifier.issue1-
dc.identifier.spagearticle no. 145-
dc.identifier.epagearticle no. 145-
dc.identifier.eissn1466-609X-
dc.identifier.isiWOS:000375770900001-
dc.identifier.issnl1364-8535-

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