The prognostic value of two-dimensional speckle tracking echocardiography of left ventricle in patients with septic shock

doi:10.3877/cma.j.issn.2096-1537.2018.04.009

Abstract

Abstract:

Objective

To evaluate long-term prognosis among septic shock patients by stratified two-dimensional speckle tracking imaging.

Methods

38 septic shock survivors were followed up for 6 months and 35 matched healthy people as control. The assessment of longitudinal and circumferential strains of the endocardium, myocardium, epicardium, and global myocardium was performed with the stratified speckle tracking imaging technique (GE vivid E9 and Echopac).

Results

(1)There was no significant difference in heart rate between septic shock group and control group (F=1.668, P=0.177). In septic shock group, LVEF did not change in the first follow-up month (P>0.05), but decreased significantly both in the third and in the sixth follow-up month (all P<0.05). There was a significant difference in LVEF of the sixth follow-up month and E/Em of the first, third, sixth follow-up month between groups (all P<0.05). (2)There was no significant change in heart rate or E/Em among different follow-up time points in septic shock group (P>0.05). LVEF and the absolute value of GLS, GRS, GCS were significantly reduced in 6 months′ follow up; LVEDV significantly increased in 6 months′ follow up (all P<0.05). (3)The longitudinal and circumferential strains of the endocardium, myocardium, and epicardium in septic shock group were significantly lower than those in healthy control group (all P<0.05).

Conclusion

The longitudinal and circumferential strains of the endocardium, myocardium, epicardium and global myocardium in septic shock patients are all decreased afterwards. The stratified speckle tracking imaging technique can be used to evaluate changes in myocardial systolic function. Moreover, this noninvasive assessment can provide predictive values for prognosis of cardiac function in septic shock patients and therefore guide clinical treatment.

Key words: Septic shock, Ventricular function, Two-dimensional speckle tracking, Strain, Stratified speckling tracking imaging

Xiuxiu Wu, Yong Chen, Ruiqiang Zheng, Fei Yang, Yong Ma, Haidi Yu, Jing Yuan, Yang Zhang. The prognostic value of two-dimensional speckle tracking echocardiography of left ventricle in patients with septic shock[J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2018, 04(04): 338-342.

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URL: https://icu.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2096-1537.2018.04.009

https://icu.cma-cmc.com.cn/EN/Y2018/V04/I04/338

Figures/Tables 2

References 12

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组别		心率（次/分）	LVEDV（ml）	LVEF（%）	GLS	GRS	GCS	E/Em
健康对照组（35例）		73.89±5.38	98.43±2.40	0.61±0.02	-21.11±1.06	33.10±1.10	-23.21±0.71	9.02±0.51
脓毒性休克组（33例）		?	?	?	?	?	?	?
?	1个月	76.03±5.10	99.52±3.68	0.58±0.05	-18.15±1.89^a	30.30±2.68^a	-18.05±1.60^a	10.26±1.17^a
?	3个月	75.85±4.69	99.52±3.68	0.56±0.05^a	-17.36±2.23^a	29.38±2.87^a	-17.30±2.13^a	10.28±1.17^a
?	6个月	76.27±4.66	103.48±9.39^abc	0.55±0.06^ab	-16.74±3.46^ab	28.76±3.65^ab	-16.89±3.04^ab	10.51±1.05^a
F值		1.668	5.533	7.585	24.040	16.999	71.045	15.114
P值		0.177	0.001	0.000	0.000	0.000	0.000	0.000

组别		心率（次/分）	LVEDV（ml）	LVEF（%）	GLS	GRS	GCS	E/Em
健康对照组（35例）		73.89±5.38	98.43±2.40	0.61±0.02	-21.11±1.06	33.10±1.10	-23.21±0.71	9.02±0.51
脓毒性休克组（33例）		?	?	?	?	?	?	?
?	1个月	76.03±5.10	99.52±3.68	0.58±0.05	-18.15±1.89^a	30.30±2.68^a	-18.05±1.60^a	10.26±1.17^a
?	3个月	75.85±4.69	99.52±3.68	0.56±0.05^a	-17.36±2.23^a	29.38±2.87^a	-17.30±2.13^a	10.28±1.17^a
?	6个月	76.27±4.66	103.48±9.39^abc	0.55±0.06^ab	-16.74±3.46^ab	28.76±3.65^ab	-16.89±3.04^ab	10.51±1.05^a
F值		1.668	5.533	7.585	24.040	16.999	71.045	15.114
P值		0.177	0.001	0.000	0.000	0.000	0.000	0.000

组别		纵向应变			环向应变
组别		内膜	中层	外膜	内膜	中层	外膜
健康对照组（35例）		-24.91±1.89	-22.43±1.41	-19.70±1.20	-33.88±1.90	-20.79±1.24	-11.71±1.32
脓毒性休克组（33例）		?	?	?	?	?	?
?	1个月	-21.35±2.14^ac	-18.88±2.36^a	-17.85±2.80^a	-29.69±2.17^ac	-18.66±1.78^a	-10.46±1.22^ac
?	3个月	-19.20±2.64^ab	-18.39±2.44^a	-17.31±3.06^a	-27.59±1.63^ab	17.71±2.03^a	-9.74±1.30^ab
?	6个月	-18.04±2.71^abc	-17.48±3.16^ab	-16.34±3.86^ab	-26.49±2.03^abc	16.71±3.11^abc	-8.76±1.61^abc
F值		55.546	24.821	8.226	95.978	23.488	27.744
P值		0.000	0.000	0.000	0.000	0.000	0.000

组别		纵向应变			环向应变
组别		内膜	中层	外膜	内膜	中层	外膜
健康对照组（35例）		-24.91±1.89	-22.43±1.41	-19.70±1.20	-33.88±1.90	-20.79±1.24	-11.71±1.32
脓毒性休克组（33例）		?	?	?	?	?	?
?	1个月	-21.35±2.14^ac	-18.88±2.36^a	-17.85±2.80^a	-29.69±2.17^ac	-18.66±1.78^a	-10.46±1.22^ac
?	3个月	-19.20±2.64^ab	-18.39±2.44^a	-17.31±3.06^a	-27.59±1.63^ab	17.71±2.03^a	-9.74±1.30^ab
?	6个月	-18.04±2.71^abc	-17.48±3.16^ab	-16.34±3.86^ab	-26.49±2.03^abc	16.71±3.11^abc	-8.76±1.61^abc
F值		55.546	24.821	8.226	95.978	23.488	27.744
P值		0.000	0.000	0.000	0.000	0.000	0.000

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