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Value of speckle-tracking echocardiography changes in monitoring myocardial dysfunction during treatment of sepsis: potential prognostic implications

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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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Funding

CNPq (Brazilian Council for Scientific and Technological Development) partly supported the study.

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Authors and Affiliations

  1. Postgraduate Course of Infectious Diseases and Tropical Medicine, School of Medicine, Universidade Federal de Minas Gerais, Av. Professor Alfredo Balena, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, 30130100, Brazil

    Mariana de Braga Lima Carvalho Canesso, Vandack Nobre & Maria Carmo Pereira Nunes

  2. Hospital das Clinicas, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil

    Mariana de Braga Lima Carvalho Canesso, Isabela Nascimento Borges, Thiago Adriano de Deus Queiroz Santos, Vandack Nobre & Maria Carmo Pereira Nunes

  3. Erasmus University Rotterdam -Erasmus MC, Rotterdam, The Netherlands

    Tijmen Hermen Ris

  4. Mater Dei Hospital, Belo Horizonte, Brazil

    Marcio Vinicius Lins de Barros

  5. Núcleo Interdiciplinar de Investigação em Medicina Intensiva (NIIMI), Belo Horizonte, Brazil

    Mariana de Braga Lima Carvalho Canesso, Isabela Nascimento Borges, Vandack Nobre & Maria Carmo Pereira Nunes

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  1. Mariana de Braga Lima Carvalho Canesso
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  2. Isabela Nascimento Borges
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  3. Thiago Adriano de Deus Queiroz Santos
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  5. Marcio Vinicius Lins de Barros
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  6. Vandack Nobre
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  7. Maria Carmo Pereira Nunes
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Correspondence to Maria Carmo Pereira Nunes.

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de Braga Lima Carvalho Canesso, M., Borges, I.N., de Deus Queiroz Santos, T.A. et al. Value of speckle-tracking echocardiography changes in monitoring myocardial dysfunction during treatment of sepsis: potential prognostic implications. Int J Cardiovasc Imaging 35, 855–859 (2019). https://doi.org/10.1007/s10554-018-01525-1

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  • DOI: https://doi.org/10.1007/s10554-018-01525-1

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