使用三维和二维斑点追踪超声心动图评估脓毒症或脓毒性休克患者左心室心肌形变的系列变化
Serial changes in left ventricular myocardial deformation in sepsis or septic shock using three-dimensional and two-dimensional speckle tracking echocardiography.
作者信息
Yan Xiaojun, Li Yuman, Liu Juanjuan, Zhou Ting, Zhou Yi, Sun Wei, Sun Chenchen, Ma Jing, Zhang Li, Shang You, Xie Mingxing
机构信息
Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China.
出版信息
Front Cardiovasc Med. 2022 Aug 4;9:925367. doi: 10.3389/fcvm.2022.925367. eCollection 2022.
BACKGROUND
This study aimed to investigate the serial changes in left ventricular (LV) myocardial deformation in patients with sepsis using three-dimensional (3D) and two-dimensional (2D) speckle tracking echocardiography (STE).
METHODS
In this single-center, prospective, and observational study, we included 59 patients diagnosed with sepsis or septic shock in the intensive care unit and 40 healthy controls. Left ventricular ejection fraction (LVEF), left ventricular global longitudinal strain (GLS), and global circumferential strain (GCS) assessed by 3D STE and 2D STE were obtained on the first, third, fifth, seventh to the tenth day after sepsis or septic shock.
RESULTS
In patients with sepsis or septic shock, 3D and 2D LVEF were not different at each time point. GLS and GCS obtained by 3D STE and 2D STE decreased on the first day compared with the healthy group (all < 0.01). Compared with the values on the first day, GLS and GCS further decreased on the third day, while 3D and 2D LVEF did not differ. 3D and 2D STE strains were lowest on the third day and gradually improved on the seventh to the tenth day compared with values on the third day. When compared with values on the first day, 3D and 2D GLS gradually improved on the seventh to the tenth day, whereas 3D and 2D GCS on the seventh to the tenth day was not different. Although 3D and 2D STE strains were significantly increased on the seventh to the tenth day, they were not fully recovered to normality.
CONCLUSION
Although patients with sepsis or septic shock demonstrated gradual improvements in 3D and 2D STE parameters during the ten-day period, LV myocardial strain was not fully recovered to normality by the seventh to the tenth days. 3D and 2D strain imaging, used as a helpful tool for monitoring the evolution of myocardial deformation, can provide clinicians with a useful additional imaging parameter.
背景
本研究旨在使用三维（3D）和二维（2D）斑点追踪超声心动图（STE）研究脓毒症患者左心室（LV）心肌变形的系列变化。
方法
在这项单中心、前瞻性观察性研究中，我们纳入了59例在重症监护病房被诊断为脓毒症或脓毒性休克的患者以及40名健康对照者。在脓毒症或脓毒性休克后的第1天、第3天、第5天、第7天至第10天，通过3D STE和2D STE获取左心室射血分数（LVEF）、左心室整体纵向应变（GLS）和整体圆周应变（GCS）。
结果
在脓毒症或脓毒性休克患者中，3D和2D LVEF在每个时间点均无差异。与健康组相比，3D STE和2D STE获得的GLS和GCS在第1天下降（均P<0.01）。与第1天的值相比，GLS和GCS在第3天进一步下降，而3D和2D LVEF无差异。3D和2D STE应变在第3天最低，与第3天的值相比，在第7天至第10天逐渐改善。与第1天的值相比，3D和2D GLS在第7天至第10天逐渐改善，而第7天至第10天的3D和2D GCS无差异。虽然3D和2D STE应变在第7天至第10天显著增加，但未完全恢复正常。
结论
尽管脓毒症或脓毒性休克患者在10天期间3D和2D STE参数逐渐改善，但到第7天至第10天左心室心肌应变仍未完全恢复正常。3D和2D应变成像作为监测心肌变形演变的有用工具，可为临床医生提供一个有用的额外成像参数。
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