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Observational Study
. 2020 Oct 21:2020:7927353.
doi: 10.1155/2020/7927353. eCollection 2020.

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

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
Affiliations
Observational Study

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

Pham Dang Hai et al. Biomed Res Int. .

Abstract

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%; p < 0.001), 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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Conflict of interest statement

The authors declare that there are no conflicts of interest regarding the publication of this paper.

Figures

Figure 1
Figure 1
Receiver operating characteristic (ROC) curve for predicting in-hospital mortality by using the left ventricular global longitudinal strain (GLS). Area under the curve is 0.76 (cut-off: −14.1%, Se: 67%, Sp: 74%).
Figure 2
Figure 2
The in-hospital mortality in the study population classified according to the left ventricular global longitudinal strain (GLS) < −14.1% or GLS > −14.1%.
See this image and copyright information in PMC

References

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