Chen Jing, Feng Yang, Chen Jiaqi, Yin Chunmei, Xia Jiaming, Fan Li, Sun Liqun, Yang Chunjiang
Department of Ultrasound, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatric Metabolism and Inflammatory Diseases, Children's Hospital of Chongqing Medical University, Chongqing, China.
Ultrasonography Department, Chongqing Emergency Medical Center, Chongqing, China.
Sci Rep. 2025 Jul 1;15(1):20787. doi: 10.1038/s41598-025-08364-w.
In post-snakebite patient care, cardiac function is chiefly monitored through Left Ventricular Ejection Fraction (LVEF) via traditional echocardiography. This approach fails to detect early systolic dysfunction sensitively, which is key for managing envenomation-induced myocardial damage and impacts treatment and prognosis. In a study of 37 snakebite patients, individuals were grouped by severity using the Snakebite Severity Scale (SSS). Correlations between serological markers and two-dimensional speckle tracking echocardiography (2D-STE) strain parameters were analyzed, with ROC curves assessing the diagnostic effectiveness for myocardial injury. After a venomous snakebite, the study found a significant decrease in the left ventricular endocardial global longitudinal strain (GLSendo) compared to the middle and epicardium layer (p < 0.01). The circumferential strain of the apical segment (ACS) was also lower in the affected group than in the control group (p < 0.05), with more severe envenomation associated with a great reduction in both GLSendo and the ACS (p < 0.01). The sensitivity of GLSendo for diagnosing myocardial injury due to venomous snakebite was 0.935, with the cut-off was 18.7%. The finding underscores the importance of using GLSendo as part of the standard echocardiographic assessment in patient. By providing early insight into the extent of myocardial injury and informed decisions regarding treatment and patient management.
在蛇咬伤患者的后期护理中，主要通过传统超声心动图测量左心室射血分数（LVEF）来监测心脏功能。这种方法无法灵敏地检测出早期收缩功能障碍，而早期收缩功能障碍是处理蛇毒所致心肌损伤的关键，会影响治疗和预后。在一项针对37名蛇咬伤患者的研究中，使用蛇咬伤严重程度量表（SSS）按严重程度对个体进行分组。分析了血清学标志物与二维斑点追踪超声心动图（2D-STE）应变参数之间的相关性，并通过ROC曲线评估心肌损伤的诊断有效性。研究发现，毒蛇咬伤后，与中层和心外膜层相比，左心室内膜整体纵向应变（GLSendo）显著降低（p < 0.01）。患侧组的心尖段圆周应变（ACS）也低于对照组（p < 0.05），蛇毒中毒越严重，GLSendo和ACS降低越明显（p < 0.01）。GLSendo诊断毒蛇咬伤所致心肌损伤的敏感性为0.935，截断值为18.7%。这一发现强调了将GLSendo作为患者标准超声心动图评估一部分的重要性，它能为心肌损伤程度提供早期见解，并为治疗和患者管理提供明智决策。
