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  • Title: Value of speckle-tracking echocardiography changes in monitoring myocardial dysfunction during treatment of sepsis: potential prognostic implications.
    Author: de Braga Lima Carvalho Canesso M, Borges IN, de Deus Queiroz Santos TA, Ris TH, de Barros MVL, Nobre V, Nunes MCP.
    Journal: Int J Cardiovasc Imaging; 2019 May; 35(5):855-859. PubMed ID: 30847658.
    Abstract:
    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.
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