Left-ventricular global longitudinal systolic strain and strain rate can predict sepsis outcome: comparison between speckle-tracking echocardiography and tissue-Doppler imaging

Abstract

Background Strain imaging, by either tissue-Doppler imaging (TDI) velocity converted to strain or strain rate or by two-dimensional speckle-tracking echocardiography (STE) analysis, is used to evaluate abnormal left-ventricular (LV) mechanical activation patterns in sepsis. Objective The aim of this study was to predict sepsis outcomes using LV strain and strain-rate measurements as well as to establish a comparison between STE and TDI. Patients and methods This study included 32 patients (43.7±13.7 years, 21 males) [13 patients with sepsis (group 1) and 19 patients with severe sepsis/septic shock (group 2)] and a subset of 10 controls (36.5±8.7 years, eight males). In the first 24 h, color-TDI was performed for LV 16 segments, and Doppler flow profiles were reanalyzed using STE to retrieve LV peak global longitudinal systolic strain (GLSS) and global longitudinal systolic strain rate (GLSSR), which were averaged for the whole segment. Results Compared with the controls, ejection fraction (%EF) of both groups were comparable, but GLSS showed increased values (−17.5±2.9 vs. −20.2±1.6%, P Conclusion LV GLSS and GLSSR obtained using STE were more specific and showed a better correlation with both Acute Physiology and Chronic Health Evaluation II and %EF rather than TDI in predicting mortality.