Prognostic Role of Left Ventricular Systolic Function Measured by Speckle Tracking Echocardiography in Septic Shock

被引:9
作者
Pham Dang Hai [1 ]
Nguyen Thanh Binh [1 ]
Nguyen Viet Quang Hien [2 ]
Nguyen Huy Hoang [3 ]
Vu Ngoc Hoan [4 ]
Pham Nguyen Son [5 ]
Le Thi Viet Hoa [6 ]
机构
[1] 108 Mil Cent Hosp, Intens Care Unit, Hanoi, Vietnam
[2] Hue Cent Hosp, Dept Anesthesiol & Crit Care Med, Hue, Vietnam
[3] 108 Mil Cent Hosp, Dept Diagnost Imaging, Hanoi, Vietnam
[4] Mil Med Univ, Hanoi, Vietnam
[5] 108 Mil Cent Hosp, Dept Cardiol, Hanoi, Vietnam
[6] Tam Anh Gen Hosp, Intens Care Unit, Hanoi, Vietnam
关键词
GLOBAL LONGITUDINAL STRAIN; SEVERE SEPSIS; MORTALITY; DYSFUNCTION;
D O I
10.1155/2020/7927353
中图分类号
Q81 [生物工程学(生物技术)]; Q93 [微生物学];
学科分类号
071005 ; 0836 ; 090102 ; 100705 ;
摘要
Background. Left ventricular (LV) systolic dysfunction is common in septic shock. Global longitudinal strain (GLS) measured by speckle tracking echocardiography (STE) is a useful marker of intrinsic left ventricular systolic function. However, the association between left ventricular GLS and outcome in septic patients is not well understood. We performed this prospective study to investigate the prognostic value of LV systolic function utilizing speckle tracking echocardiography in patients with septic shock. Methods. All the patients with septic shock based on sepsis-3 definition admitted to the intensive care unit were prospectively studied with STE within 24 hours after the onset of septic shock. Baseline clinical and echocardiographic variables were collected. The primary outcome was in-hospital mortality. Results. During a 19-month period, 90 consecutive patients were enrolled in the study. The in-hospital mortality rate was 43.3%. Compared with survivors, nonsurvivors exhibited significantly less negative GLS (-13.1 +/- 3.3% versus -15.8 +/- 2.9%; p0.001), which reflected worse LV systolic function. The area under the ROC curves of GLS for the prediction of mortality was 0.76 (95% CI 0.67 to 0.87). Patients with GLS-14.1% showed a significantly higher mortality rate (67.7% versus 15.6%; p < 0.0001; log-rank=23.3; p < 0.0001). In the multivariate analysis, GLS (HR, 1.27; 95% CI 1.07 to 1.50, p=0.005) and SOFA scores (HR, 1.27; 95% CI 1.08 to 1.50, p=0.004) were independent predictors of in-hospital mortality. Conclusions. Our study indicated that LV systolic function measured by STE might be associated with mortality in patients with septic shock.
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页数:7
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