Nafati Cyril, Lançon Victor, Blasco Valery, Zieleskiewicz Laurent, Harti Karim, Wiramus Sandrine, Kelway Charlotte, Reydellet Laurent, Antonini François, Albanèse Jacques, Leone Marc
Service d'anesthésie et de réanimation, hôpital La Timone, Assistance Publique-Hôpitaux de Marseille, Aix Marseille Université, Marseille, France.
Service d'anesthésie et de réanimation, hôpital Nord, Assistance Publique-Hôpitaux de Marseille, Aix Marseille Université, Marseille, France.
J Clin Ultrasound. 2016 Jul 8;44(6):368-74. doi: 10.1002/jcu.22349. Epub 2016 Mar 4.
Two-dimensional-strain echocardiography (2D-strain) is a promising technique for the early detection of myocardial dysfunction. Our study was aimed to assess its feasibility in the intensive care unit (ICU). Our secondary goal was to determine if 2D-strain could predict the patient's outcome.
Conventional echocardiography and 2D-strain were performed on 64 consecutive patients admitted to our ICU. Using 2D-strain, the longitudinal deformation of the left ventricle was assessed. Feasibility of 2D-strain, diagnosis performance, and 28-day mortality prediction were determined.
2D-strain measurements could be performed in 77% of our patients. All 2D-strain variables related to ventricular performance were significantly impaired in the patients who died compared with those who survived. Strain global medium was the only independent echocardiographic variable predictor of 28-day mortality rate (odds ratio 0.60; 95% confidence interval 0.43-0.80, p = 0.002).
2D-strain measurement is feasible in ICU patients, enabling identifying early left ventricle dysfunction. Strain global medium is an independent predictor of 28-day mortality. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 44:368-374, 2016.
二维应变超声心动图（2D应变）是早期检测心肌功能障碍的一项很有前景的技术。我们的研究旨在评估其在重症监护病房（ICU）中的可行性。我们的次要目标是确定2D应变是否能预测患者的预后。
对连续入住我们ICU的64例患者进行了常规超声心动图和2D应变检查。使用2D应变评估左心室的纵向变形。确定了2D应变的可行性、诊断性能和28天死亡率预测。
77%的患者能够进行2D应变测量。与存活患者相比，死亡患者中所有与心室功能相关的2D应变变量均显著受损。应变整体均值是28天死亡率的唯一独立超声心动图变量预测因子（比值比0.60；95%置信区间0.43 - 0.80，p = 0.002）。
2D应变测量在ICU患者中是可行的，能够早期识别左心室功能障碍。应变整体均值是28天死亡率的独立预测因子。© 2016威利期刊公司。《临床超声杂志》2016年第44卷：368 - 374页
