TY - JOUR
T1 - Global Longitudinal Strain Using Speckle-Tracking Echocardiography as a Mortality Predictor in Sepsis
T2 - A Systematic Review
AU - Vallabhajosyula, Saraschandra
AU - Rayes, Hamza A.
AU - Sakhuja, Ankit
AU - Murad, Mohammad Hassan
AU - Geske, Jeffrey B.
AU - Jentzer, Jacob C.
N1 - Publisher Copyright:
© The Author(s) 2018.
PY - 2019/2/1
Y1 - 2019/2/1
N2 - The data on speckle-tracking echocardiography (STE) in patients with sepsis are limited. This systematic review from 1975 to 2016 included studies in adults and children evaluating cardiovascular dysfunction in sepsis, severe sepsis, and septic shock utilizing STE for systolic global longitudinal strain (GLS). The primary outcome was short- or long-term mortality. Given the significant methodological and statistical differences between published studies, combining the data using meta-analysis methods was not appropriate. A total of 120 studies were identified, with 5 studies (561 patients) included in the final analysis. All studies were prospective observational studies using the 2001 criteria for defining sepsis. Three studies demonstrated worse systolic GLS to be associated with higher mortality, whereas 2 did not show a statistically significant association. Various cutoffs between −10% and −17% were used to define abnormal GLS across studies. This systematic review revealed that STE may predict mortality in patients with sepsis; however, the strength of evidence is low due to heterogeneity in study populations, GLS technologies, cutoffs, and timing of STE. Further dedicated studies are needed to understand the optimal application of STE in patients with sepsis.
AB - The data on speckle-tracking echocardiography (STE) in patients with sepsis are limited. This systematic review from 1975 to 2016 included studies in adults and children evaluating cardiovascular dysfunction in sepsis, severe sepsis, and septic shock utilizing STE for systolic global longitudinal strain (GLS). The primary outcome was short- or long-term mortality. Given the significant methodological and statistical differences between published studies, combining the data using meta-analysis methods was not appropriate. A total of 120 studies were identified, with 5 studies (561 patients) included in the final analysis. All studies were prospective observational studies using the 2001 criteria for defining sepsis. Three studies demonstrated worse systolic GLS to be associated with higher mortality, whereas 2 did not show a statistically significant association. Various cutoffs between −10% and −17% were used to define abnormal GLS across studies. This systematic review revealed that STE may predict mortality in patients with sepsis; however, the strength of evidence is low due to heterogeneity in study populations, GLS technologies, cutoffs, and timing of STE. Further dedicated studies are needed to understand the optimal application of STE in patients with sepsis.
KW - echocardiography
KW - sepsis
KW - septic shock
KW - speckle-tracking echocardiography
KW - strain imaging
UR - http://www.scopus.com/inward/record.url?scp=85046013203&partnerID=8YFLogxK
U2 - 10.1177/0885066618761750
DO - 10.1177/0885066618761750
M3 - Review article
C2 - 29552957
AN - SCOPUS:85046013203
SN - 0885-0666
VL - 34
SP - 87
EP - 93
JO - Journal of Intensive Care Medicine
JF - Journal of Intensive Care Medicine
IS - 2
ER -