Jiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009, China.
Department of Cardiology, The Second Affiliated Hospital of Soochow University, Suzhou, 215000, China.
BMC Anesthesiol. 2023 Aug 11;23(1):271. doi: 10.1186/s12871-023-02186-x.
Although global longitudinal strain (GLS) is proven to be reduced and associated with adverse outcomes in septic patients, it has not been elucidated whether or not layer-specific strains are reduced. We aimed to explore the layer-specific strains of left ventricular (LV) for assessing myocardial dysfunction in septic patients.
A prospective observational study of patients with sepsis was conducted in a tertiary hospital in China. Routine two-dimensional speckle tracking echocardiography was performed within 24 h of enrollment. Demographic data, laboratory values, and clinical outcomes were collected.
We recruited 79 septic patients finally. The mean age of septic patients was 59.4 years old and 45 (57.0%) were male. The median Acute Physiology Age and Chronic Health Evaluation (APACHE II) score, and mean sequential organ failure assessment (SOFA) score of all patients were 19.0 and 7.7, respectively. According to the left ventricular ejection fraction (LVEF) value of 50%, the patients were categorized into two groups: SICM (sepsis-induced cardiomyopathy, LVEF < 50%, n = 22) and non-SICM group ( LVEF ≥ 50%, n = 57). The median LVEF of SICM and non-SICM patients were 41.9% and 58.7%, and SICM patients had less negative layer-specific strain and global strain than that of non-SICM patients. The echocardiographic comparison of non-SICM and healthy controls was conducted to explore the myocardial injuries of non-SICM patients and the non-SICM had worse LS-epi than that of controls (-18.5% vs. -21.4%, p = 0.024).
There were 72.2% (57) septic patients presented with non-SICM (LVEF ≥ 50%), and the strain value of epicardium of them was less negative than healthy controls.
尽管全球纵向应变（GLS）已被证明在脓毒症患者中降低，并与不良预后相关，但尚未阐明是否存在节段性应变降低。我们旨在探讨左心室（LV）的节段性应变，以评估脓毒症患者的心肌功能障碍。
在中国的一家三级医院进行了一项脓毒症患者的前瞻性观察性研究。在入组后 24 小时内进行常规二维斑点追踪超声心动图检查。收集人口统计学数据、实验室值和临床结果。
最终我们招募了 79 例脓毒症患者。脓毒症患者的平均年龄为 59.4 岁，其中 45 例（57.0%）为男性。所有患者的中位急性生理学和慢性健康评估（APACHE II）评分和序贯器官衰竭评估（SOFA）评分分别为 19.0 和 7.7。根据左心室射血分数（LVEF）值 50%，患者分为两组：SICM（脓毒症诱导性心肌病，LVEF<50%，n=22）和非-SICM 组（LVEF≥50%，n=57）。SICM 和非-SICM 患者的中位 LVEF 分别为 41.9%和 58.7%，SICM 患者的节段性应变和整体应变比非-SICM 患者更负。为了探讨非-SICM 患者的心肌损伤，对非-SICM 与健康对照组进行了超声心动图比较，非-SICM 患者的 LS-epi 比对照组更差（-18.5% vs. -21.4%，p=0.024）。
72.2%（57 例）脓毒症患者表现为非-SICM（LVEF≥50%），其心外膜应变值比健康对照组更负。
