Study on two-dimensional speckle tracing imaging for left ventricular function in sepsis patients

Abstract

Objective To study the clinical significance of two-dimensional speckle tracking imaging (2D-STI) in the treatment of left ventricular function in patients with sepsis. Methods Totally 81 patients with sepsis who were hospitalized in the Department of Intensive Care Medicine of Zhejiang Provincial People's Hospital from January 2014 to December 2015 were selected as the observation group, while 81 healthy subjects in the same period as the control group. The general data, left ventricular end systolic diameter (LVESd), left ventricular end diastolic diameter (LVEDd), interventricular septum diastolic (IVSD), stroke volume (SV), left ventricular ejection fraction (LVEF), early diastolic peak of mitral orifice (E peak), late diastolic peak of mitral orifice (A peak), E-wave velocity descent time (DT), global longitudinal strain (GLS), global radial strain (GRS), global circumferential strain (GCS), standard deviation of time to peak systolic longitudinal strain (Tssl-SD), standard deviation of time to peak systolic radial strain (Tssr-SD), standard deviation of time to peak systolic circumferrntial strain (Tssc-SD), maximum difference of Tssl (Tssl-Dif), maximum difference of Tssr (Tssr-Dif), maximum difference of Tssc (Tssc-Dif) of these two groups were compared. The relations between two-dimensional strain parameters and LVEF were analyzed by Spearman correlation. Results LVEF in the observation group [(62 ± 5)% vs. (68 ± 7)%] was significantly lower than that in the control group (t = 5.109, P < 0.001). In the observation group, GLS [(-18.4 ± 3.1)% vs. (-20.3 ± 2.1)%], GRS [(28.3 ± 2.1)% vs. (26.6 ± 4.2)%], GCS [(-23.8 ± 1.2)% vs. (-24.4 ± 2.4)%], Tssl-SD [(45.3 ± 3.2) ms vs. (19.3 ± 1.3) ms], Tssr-SD [(32.1 ± 2.9) ms vs. (21.3 ± 1.8) ms], Tssl-Dif [(103 ± 13) ms vs. (30 ± 25) ms], Tssr-Dif [(281 ± 23) ms vs. (160 ± 11) ms], and Tssc-Dif [(242 ± 12) ms vs. (169 ± 13) ms] were significantly higher than those in the control group (t = 4.828, 4.983, 2.165, 77.772, 31.516, 0.753, 35.843, 27.645; all P < 0.05). Spearman correlation analysis showed that GLS (r = -0.644, P = 0.005), Tssl-SD (r = -3.553, P < 0.001), Tssr-SD (r = -3.715, P < 0.001), Tssl-Dif (r = -2.944, P < 0.001), Tssr-Dif (r = -0.842, P = 0.003) and Tssc-Dif (r = -0.811, P = 0.003) were negatively associated with LVEF, while GCS (r = -0.085, P = 0.513) and GRS (r = -0.054, P = 0.517) were not associated with LVEF. Conclusion The 2D-STI index can objectively evaluate the systolic dysfunction and synchrony of left ventricle, and has important value in the early diagnosis of cardiac conditions in sepsis patients. Key words: Ultrasound cardiogram; Two-dimensional speckle tracking imaging; Left ventricle